Respiratory and Critical Care Medicine, Inter-Departmental Division of Critical Care Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.
Crit Care Med. 2009 Oct;37(10 Suppl):S457-61. doi: 10.1097/CCM.0b013e3181b6f35c.
Loss of muscle mass, nerve dysfunction, and resultant weakness and functional disability represent important and lasting morbidities of an episode of critical illness. As investigators increasingly incorporate long-term functional, neuropsychological, and quality-of-life outcomes into their studies, more data are accruing that support the existence of often devastating and irreversible sequelae of severe illness and treatment in an intensive care unit. This review highlights early quality-of-life literature that supports significant physical dysfunction after intensive care unit treatment and more recent longitudinal studies up to 5 yrs after intensive care unit discharge, which clearly implicate nerve and muscle dysfunction as contributors to this reported disability. Additional follow-up work is needed to understand the pathophysiology of this injury, the spectrum of physical disability, and its associated risk factors. These data are crucial to inform risk-stratification and future rehabilitation interventions, both during the intensive care unit admission and after hospital discharge as patients reintegrate within their community and workplace.
肌肉质量丧失、神经功能障碍，以及由此导致的虚弱和功能障碍，是重症疾病发作的重要且持久的病态。随着研究人员越来越多地将长期的功能、神经心理学和生活质量结果纳入他们的研究中，更多的数据支持了重症监护病房中严重疾病和治疗后存在的破坏性和不可逆转的后遗症。这篇综述强调了早期的生活质量文献，这些文献支持重症监护病房治疗后存在明显的身体功能障碍，以及最近的纵向研究，最长可达重症监护病房出院后 5 年，这些研究明确表明神经和肌肉功能障碍是导致这种报告残疾的原因之一。需要进一步的随访工作来了解这种损伤的病理生理学、身体残疾的范围及其相关的危险因素。这些数据对于告知风险分层和未来的康复干预措施至关重要，包括在重症监护病房住院期间和出院后，当患者重新融入社区和工作场所时。
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