Department of Surgery, Division of Surgical/Critical Care, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Crit Care Med. 2010 Sep;38(9 Suppl):S452-9. doi: 10.1097/CCM.0b013e3181ec5697.
We describe the physiology of aging and its effect on elderly, critically ill, surgical patients. Postoperative age-specific complications and their management will be reviewed. The number of elderly persons, defined as those >65 yrs of age, is the fastest growing segment of the U.S. population. As a result, the frequency of surgery, both elective and emergent, performed on elderly patients will increase. Aging is associated with a decrease in the physiologic reserve; thus, many elderly persons are unable to compensate for the increased metabolic demands that accompany acute illness or injury. This inability to compensate leads to increased rates of postoperative complications and death. Aggressive, goal-directed management in the surgical intensive care unit is beneficial for the geriatric patient. The management of the elderly, surgical, critical care patient is extremely challenging. Understanding age-related physiologic changes will help guide treatment to maximize outcome and prevent complications.
我们描述了衰老的生理学及其对老年、危重症、手术患者的影响。术后特定于年龄的并发症及其管理将被审查。被定义为 >65 岁的老年人的数量是美国人口增长最快的部分。因此，对老年患者进行的择期和紧急手术的频率将会增加。衰老是与生理储备减少相关的；因此，许多老年人无法补偿伴随急性疾病或损伤而来的增加的代谢需求。这种无法补偿导致术后并发症和死亡的发生率增加。在外科重症监护病房进行积极的、以目标为导向的管理对老年患者是有益的。老年、外科、重症监护患者的管理极具挑战性。了解与年龄相关的生理变化将有助于指导治疗，以最大限度地提高结果并预防并发症。
