Department of Rehabilitation Science, University at Buffalo, 515 Kimball Tower, Buffalo, NY 14214 (USA).
Department of Physical Therapy, Mount St Mary's University, Los Angeles, California.
Phys Ther. 2018 Aug 1;98(8):631-645. doi: 10.1093/ptj/pzy059.
Post-intensive care syndrome (PICS) is a constellation of new or worsening impairments in physical, mental, or cognitive abilities or a combination of these in individuals who have survived critical illness requiring intensive care.
The 2 purposes of this systematic review were to identify the scope and magnitude of physical problems associated with PICS during the first year after critical illness and to use the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework to elucidate impairments of body functions and structures, activity limitations, and participation restrictions associated with PICS.
Ovid MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL Plus with Full Text (EBSCO), Web of Science, and Embase were searched from inception until March 7, 2017.
Two reviewers screened titles, abstracts, and full text to independently determine study eligibility based on inclusion and exclusion criteria.
Study methodological quality was assessed using the Newcastle-Ottawa Scale. Data describing study methods, design, and participant outcomes were extracted.
Fifteen studies were eligible for review. Within the first year following critical illness, people who had received intensive care experienced impairments in all 3 domains of the ICF (body functions and structures, activity limitations, and participation restrictions). These impairments included decreased pulmonary function, reduced strength of respiratory and limb muscles, reduced 6-minute walk test distance, reduced ability to perform activities of daily living and instrumental activities of daily living, and reduced ability to return to driving and paid employment.
The inclusion of only 15 observational studies in this review may limit the generalizability of the findings.
During the first year following critical illness, individuals with PICS experienced physical impairments in all 3 domains of the ICF.
创伤后综合征（PICS）是指在经历过需要重症监护的重症疾病后存活下来的个体中，出现新的或恶化的身体、心理或认知能力损害，或这些损害的组合。
本次系统综述有两个目的，一是确定与创伤后综合征相关的身体问题的范围和严重程度，二是使用世界卫生组织的国际功能、残疾和健康分类（ICF）框架阐明与创伤后综合征相关的身体功能和结构、活动受限和参与受限的损害。
Ovid MEDLINE、Cochrane 系统评价数据库、Cochrane 对照试验中心注册库（CENTRAL）、PubMed、CINAHL Plus with Full Text（EBSCO）、Web of Science 和 Embase 从建库至 2017 年 3 月 7 日进行了检索。
两位评审员独立筛选标题、摘要和全文，根据纳入和排除标准确定研究的资格。
研究方法学质量使用纽卡斯尔-渥太华量表进行评估。提取描述研究方法、设计和参与者结局的数据。
15 项研究符合纳入标准。在重症疾病后的第一年，接受过重症监护的人在 ICF 的所有 3 个领域（身体功能和结构、活动受限和参与受限）都存在损害。这些损害包括肺功能下降、呼吸和肢体肌肉力量减弱、6 分钟步行试验距离缩短、日常生活活动和工具性日常生活活动能力下降、以及恢复驾驶和有薪工作的能力下降。
本次综述仅纳入了 15 项观察性研究，这可能限制了研究结果的普遍性。
在重症疾病后的第一年，创伤后综合征患者在 ICF 的所有 3 个领域都存在身体功能损害。
