Stevens Robert D, Nyquist Paul A
Department of Anesthesiology Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Neurol Clin. 2008 May;26(2):469-86, ix. doi: 10.1016/j.ncl.2008.02.004.
Cerebral dysfunction and injury in the ICU presents as focal neurologic deficits, seizures, coma, and delirium. These syndromes may result from a primary brain insult, such as stroke or trauma, but commonly are a complication of a systemic insult, such as cardiac arrest, hypoxemia, sepsis, metabolic derangements, and pharmacologic exposures. Many survivors of critical illness have cognitive impairment, which is believed to underlie the poor long-term functional status and quality of life observed in many critical illness survivors. Although progress has been made in characterizing the epidemiology of cerebral dysfunction in the ICU, more research is needed to elucidate underlying mechanisms that might represent targets for therapeutic intervention.
重症监护病房(ICU)中的脑功能障碍和损伤表现为局灶性神经功能缺损、癫痫发作、昏迷和谵妄。这些综合征可能源于原发性脑损伤,如中风或创伤,但通常是全身性损伤的并发症,如心脏骤停、低氧血症、脓毒症、代谢紊乱和药物暴露。许多危重病幸存者存在认知障碍,这被认为是许多危重病幸存者长期功能状态不佳和生活质量低下的原因。尽管在描述ICU中脑功能障碍的流行病学方面已取得进展,但仍需要更多研究来阐明可能成为治疗干预靶点的潜在机制。