Baumbach Philipp, Götz Theresa, Günther Albrecht, Weiss Thomas, Meissner Winfried
1Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany. 2Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany. 3Biomagnetic Center, Hans-Berger-Klinik for Neurology, Jena University Hospital, Jena, Germany. 4Department of Biological and Clinical Psychology, Friedrich Schiller University of Jena, Jena, Germany.
Crit Care Med. 2017 Jun;45(6):e567-e574. doi: 10.1097/CCM.0000000000002309.
There is growing evidence for increased levels of pain and reduced health-related quality of life in survivors of critical illness. Recent studies showed marked small nerve fiber pathology in critically ill patients, which may contribute to chronic pain states and reduced physical recovery after ICU discharge. Primary objective of this study was the comparison of somatosensory functions between survivors of critical illness 6 months after ICU discharge and controls. In post hoc analyses, we aimed to identify associations between small fiber deficits, pain, health-related quality of life, and clinical data.
Cross-sectional study.
Study in critical illness survivors.
Critical illness survivors (n = 84) and controls (n = 44).
None.
Somatosensory functions were assessed with validated quantitative sensory testing. Pain and pain-related disability were assessed with the chronic pain grade questionnaire. Health-related quality of life was assessed by means of the Short Form-36. Compared with controls, former patients showed significantly increased thermal detection thresholds and more abnormal values in thermal testing, indicating reduced small fiber functioning. In addition, compared to patients without significant small fiber deficits (n = 46, 54.8%), patients with significant small fiber deficits (n = 38, 45.2%) reported higher average pain intensity, pain-related disability, and reduced physical health-related quality of life in the SF-36.
A large portion of former critically ill patients show small fiber deficits which seem to be associated with increased pain and reduced physical health-related quality of life. Screening of somatosensory functions in the (post-) acute setting could possibly help to identify patients at risk of long-term impairments.
越来越多的证据表明，危重症幸存者的疼痛程度增加，与健康相关的生活质量下降。最近的研究显示，危重症患者存在明显的小神经纤维病变，这可能导致慢性疼痛状态，并降低重症监护病房（ICU）出院后的身体恢复能力。本研究的主要目的是比较ICU出院6个月后的危重症幸存者与对照组之间的体感功能。在事后分析中，我们旨在确定小纤维缺陷、疼痛、与健康相关的生活质量和临床数据之间的关联。
横断面研究。
对危重症幸存者的研究。
危重症幸存者（n = 84）和对照组（n = 44）。
无。
采用经过验证的定量感觉测试评估体感功能。用慢性疼痛分级问卷评估疼痛和与疼痛相关的残疾情况。通过简短形式-36评估与健康相关的生活质量。与对照组相比， former patients的热觉检测阈值显著升高，热测试中的异常值更多，表明小纤维功能降低。此外，与无明显小纤维缺陷的患者（n = 46，54.8%）相比，有明显小纤维缺陷的患者（n = 38，45.2%）在SF-36中报告的平均疼痛强度、与疼痛相关的残疾程度更高，与身体健康相关的生活质量更低。
很大一部分 former critically ill patients存在小纤维缺陷，这似乎与疼痛增加和与身体健康相关的生活质量降低有关。在（急性）后阶段筛查体感功能可能有助于识别有长期损伤风险的患者。
原文中“former patients”和“former critically ill patients”表述不太准确，可能会影响理解，推测这里可能想表达的是“之前的患者”“之前的危重症患者”等意思。
