Riessen R, Kluge S, Janssens U, Kierdorf H, Bodmann K F, Busch H-J, John S, Möckel M
Internistische Intensivstation, Department für Innere Medizin, Universitätsklinikum Tübingen, Tübingen, Deutschland.
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Internist (Berl). 2017 Jun;58(6):550-555. doi: 10.1007/s00108-017-0250-z.
Intensive care medicine is an important and integral part of internal medicine. Modern intensive care medicine permits survival of many patients with severe and life-threatening internal diseases in acute situations. Decisive for therapeutic success is often not the application of complicated and expensive medical technologies, but rather the rapid diagnosis and identification of core issues, with immediate and competent initiation of standard treatment regimens. An adequately staffed, well-organized interprofessional team is of central importance. With the application of standard therapies, it has been increasingly demonstrated that "less is more", and that personalized treatment concepts are better than aggressive strategies with higher therapeutic goals. In accordance with the Choosing wisely recommendations of the American societies for intensive care medicine, the extended board of the Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN) has formulated five positive and five negative recommendations reflecting these principles. The current paper is an updated version of the manuscript originally published in the Deutsches Ärzteblatt. When applying these recommendations, it is important to consider that intensive care patients are very complex; therefore, the applicability of these principles must be assessed on an individual basis and, where necessary, modified appropriately.
重症医学是内科的一个重要且不可或缺的组成部分。现代重症医学使许多患有严重及危及生命的内科疾病的患者在急性情况下得以存活。治疗成功的关键往往不是应用复杂且昂贵的医疗技术,而是快速诊断和识别核心问题,并立即启动标准治疗方案且实施得当。一个人员配备充足、组织良好的跨专业团队至关重要。随着标准疗法的应用,越来越多地证明了“少即是多”,而且个性化治疗理念优于具有更高治疗目标的激进策略。根据美国重症医学会的明智选择建议,德国内科重症医学与急诊医学协会(DGIIN)扩大委员会制定了五项正面和五项负面建议以反映这些原则。本文是最初发表在《德国医学杂志》上的手稿的更新版本。在应用这些建议时,重要的是要考虑到重症患者非常复杂;因此,必须根据个体情况评估这些原则的适用性,并在必要时进行适当修改。