Section of Pulmonary/Critical Care Medicine, Washington Hospital Center, Washington, DC, USA.
Crit Care Med. 2011 Feb;39(2):371-9. doi: 10.1097/CCM.0b013e3181fd66e5.
As critical care advances and intensive care unit mortality declines, the number of survivors of critical illness is increasing. These survivors frequently experience long-lasting complications of critical care. As a result, it is important to understand these complications and implement evidence-based practices to minimize them.
Database searches and review of relevant medical literature.
Critical illness and intensive care unit care influence a wide range of long-term patient outcomes, with some impairments persisting for 5-15 yrs. Impaired pulmonary function, greater healthcare utilization, and increased mortality are observed in intensive care survivors. Neuromuscular weakness and impairments in both physical function and related aspects of quality of life are common and may be long-lasting. These complications may be reduced by multidisciplinary physical rehabilitation initiated early and continued throughout the intensive care unit care stay and by providing patient education for self-rehabilitation after hospital discharge. Common neuropsychiatric complications, including cognitive impairment and symptoms of depression and posttraumatic stress disorder, are frequently associated with intensive care unit sedation, delirium or delusional memories, and long-term impairments in quality of life.
Survivors of critical illness are frequently left with a legacy of long-term physical, neuropsychiatric, and quality of life impairments. Understanding patient and intensive care risk factors can help identify patients who are most at risk of these complications. Furthermore, modifiable risk factors and beneficial interventions are increasingly being identified to help inform practical management recommendations to reduce the prevalence and impact of these long-term complications.
随着危重病医学的进步和重症监护病房死亡率的下降，危重病幸存者的数量正在增加。这些幸存者经常经历重症监护的长期并发症。因此，了解这些并发症并实施基于证据的实践以最大程度地减少它们非常重要。
数据库搜索和相关医学文献综述。
危重病和重症监护病房的护理会影响广泛的长期患者结局，一些损伤会持续 5-15 年。重症监护幸存者存在肺功能受损、更多的医疗保健利用和更高的死亡率。神经肌肉无力以及身体功能和相关生活质量方面的损伤较为常见，并且可能会持续很长时间。通过早期开始并在重症监护病房治疗期间持续进行多学科物理康复，以及为患者提供出院后自我康复的教育，可以减少这些并发症。常见的神经精神并发症，包括认知障碍以及抑郁和创伤后应激障碍的症状，常与重症监护病房镇静、谵妄或妄想记忆以及长期生活质量受损有关。
危重病幸存者经常留下长期身体、神经精神和生活质量受损的后遗症。了解患者和重症监护病房的风险因素可以帮助确定最容易发生这些并发症的患者。此外，越来越多的可改变的风险因素和有益的干预措施被确定，以帮助提供实用的管理建议，以降低这些长期并发症的发生率和影响。
