Rawal Gautam, Yadav Sankalp, Kumar Raj
Attending Consultant, Respiratory Intensive Care, Max Super Specialty Hospital, Saket, New Delhi, India.
General Duty Medical Officer-II, Department of Medicine & TB, Chest Clinic Moti Nagar, North Delhi Municipal Corporation, New Delhi, India.
J Transl Int Med. 2017 Jun 30;5(2):90-92. doi: 10.1515/jtim-2016-0016. eCollection 2017 Jun.
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU.All critical care survivors should be evaluated for PICS and those having signs and symptoms of it should be managed by a multidisciplinary team which includes critical care physician, neuro-psychiatrist, physiotherapist and respiratory therapist, with the use of pharmacological and non-apharmacological interventions. This can be achieved through an organizational change and improvement, knowing the high rate of incidence of PICS and its adverse effects on the survivor's life and daily activities and its effect on the survivor's family.
在过去十年中,由于重症医学的进步,危重症患者的生存率有所提高。这些幸存者中的一些人在重症监护病房(ICU)接受治疗后会出现认知、精神和/或身体残疾,现在这被认为是重症监护后综合征(PICS)。鉴于医学院校对PICS的认识有限,这一方面往往被忽视,这可能会导致患者生活质量下降,并给这些患者及其家人带来很多痛苦。应通过在ICU期间尽量减少镇静和早期活动来努力预防PICS。所有重症监护幸存者都应接受PICS评估,有相关体征和症状的患者应由多学科团队管理,该团队包括重症医生、神经精神科医生、物理治疗师和呼吸治疗师,并使用药物和非药物干预措施。这可以通过组织变革和改进来实现,因为了解PICS的高发病率及其对幸存者生活和日常活动的不利影响以及对幸存者家庭的影响。