Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Crit Care Med. 2010 Oct;38(10 Suppl):S582-9. doi: 10.1097/CCM.0b013e3181f2002a.
Iatrogenic illnesses are those that arise as a result of the process of medical care and are potentially preventable by improvements to patient care. The term is commonly used to denote medical error; however, for the critically ill patient the term has a much more fundamental meaning. Critical illness is inherently iatrogenic: it only develops in those patients who have been resuscitated from an otherwise life-threatening disorder, and its subsequent evolution is shaped by the beneficial and adverse consequences of therapeutic and supportive interventions. The construct of organ dysfunction describes both the nature of this support and its inadvertent consequences. This review explores evolving evidence on the iatrogenic nature of critical illness and the implications of an iatrogenic model of disease on the taxonomy, management, and prevention of the complex processes that threaten to limit the survival of the critically ill patient.
医源性疾病是指由于医疗过程而产生的、有可能通过改进患者护理来预防的疾病。该术语通常用于表示医疗差错；然而，对于重症患者来说，这个术语有着更根本的含义。重症疾病本质上就是医源性的：它只发生在那些从危及生命的疾病中复苏过来的患者身上，其后续的发展受到治疗和支持干预的有益和不利后果的影响。器官功能障碍的概念描述了这种支持的性质及其意外后果。这篇综述探讨了重症疾病的医源性本质的最新证据，以及疾病的医源性模型对威胁限制重症患者生存的复杂过程的分类、管理和预防的影响。
