Griffith David M, Vale Matthew E, Campbell Christine, Lewis Steff, Walsh Timothy S
Department of Anaesthesia, Critical Care and Pain Medicine, Edinburgh Medical School, University of Edinburgh, UK.
Department of Anaesthesia, Critical Care and Pain Medicine, Edinburgh Medical School, University of Edinburgh, UK.
J Crit Care. 2016 Jun;33:192-9. doi: 10.1016/j.jcrc.2016.01.011. Epub 2016 Jan 13.
Physical weakness is common after critical illness; however, it is not clear how best to treat it. Inflammation characterizes critical illness, is associated with loss of muscle mass during critical illness, and potentially modifies post-intensive care unit (ICU) recovery. We sought to identify published reports on the prevalence of systemic inflammation after critical illness and its association with physical recovery.
This is a systematic review of the literature from MEDLINE, EMBASE, CINAHL, CPCI-SSH, and CPCI-S from January 1982 to December 2011.
From 7433 references, 207 full-text articles were reviewed, 57 were eligible, and 22 were included. Inflammation was present in most patients at ICU discharge according to C-reactive protein concentration (range, 70%-100%), procalcitonin (range, 89%-100%), tumor necrosis factor α (100%), and systemic inflammatory response syndrome criteria (range, 92%-95%). Fewer patients had elevated myeloperoxidase concentrations (range, 0%-56%). At hospital discharge, 9 (90%) of 10 chronic obstructive pulmonary disease patients had elevated C-reactive protein. No studies tested the association between inflammation and physical recovery.
Inflammation is present in most patients at ICU discharge, but little is known or has been investigated about persistent inflammation after this time point. No studies have explored the relationship between persistent inflammation and physical recovery. Further research is proposed.
危重症后身体虚弱很常见；然而，目前尚不清楚最佳的治疗方法。炎症是危重症的特征，与危重症期间肌肉量的减少有关，并可能影响重症监护病房（ICU）后的恢复。我们试图确定已发表的关于危重症后全身炎症的患病率及其与身体恢复的关联的报告。
这是一项对1982年1月至2011年12月期间来自MEDLINE、EMBASE、CINAHL、CPCI - SSH和CPCI - S的文献的系统评价。
从7433篇参考文献中，筛选了207篇全文文章，57篇符合条件，22篇被纳入。根据C反应蛋白浓度（范围为70% - 100%）、降钙素原（范围为89% - 100%）、肿瘤坏死因子α（100%）和全身炎症反应综合征标准（范围为92% - 95%），大多数患者在ICU出院时存在炎症。髓过氧化物酶浓度升高的患者较少（范围为0% - 56%）。在出院时，10例慢性阻塞性肺疾病患者中有9例（90%）C反应蛋白升高。没有研究测试炎症与身体恢复之间的关联。
大多数患者在ICU出院时存在炎症，但关于该时间点之后的持续性炎症知之甚少或尚未进行研究。没有研究探讨持续性炎症与身体恢复之间的关系。建议进一步开展研究。
