Loss Sergio Henrique, Nunes Diego Silva Leite, Franzosi Oellen Stuani, Salazar Gabriela Soranço, Teixeira Cassiano, Vieira Silvia Regina Rios
Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
Unidade de Terapia Intensiva, Hospital de Clínicas de Porto Alegre - Porto Alegre (RS), Brasil.
Rev Bras Ter Intensiva. 2017 Jan-Mar;29(1):87-95. doi: 10.5935/0103-507X.20170013.
The technological advancements that allow support for organ dysfunction have led to an increase in survival rates for the most critically ill patients. Some of these patients survive the initial acute critical condition but continue to suffer from organ dysfunction and remain in an inflammatory state for long periods of time. This group of critically ill patients has been described since the 1980s and has had different diagnostic criteria over the years. These patients are known to have lengthy hospital stays, undergo significant alterations in muscle and bone metabolism, show immunodeficiency, consume substantial health resources, have reduced functional and cognitive capacity after discharge, create a sizable workload for caregivers, and present high long-term mortality rates. The aim of this review is to report on the most current evidence in terms of the definition, pathophysiology, clinical manifestations, treatment, and prognosis of persistent critical illness.
支持器官功能障碍的技术进步提高了最危重患者的生存率。其中一些患者在最初的急性危急状况中存活下来，但仍持续存在器官功能障碍，并长期处于炎症状态。自20世纪80年代以来就有对这组危重患者的描述，多年来其诊断标准也有所不同。已知这些患者住院时间长，肌肉和骨骼代谢发生显著变化，表现出免疫缺陷，消耗大量医疗资源，出院后功能和认知能力下降，给护理人员带来相当大的工作量，且长期死亡率高。本综述的目的是报告关于持续性危重病的定义、病理生理学、临床表现、治疗和预后的最新证据。
