Ekim Ayfer
Faculty of Health Sciences, Department of Nursing, Istanbul Bilgi University, Istanbul, Turkey.
Compr Child Adolesc Nurs. 2020 Mar;43(1):15-21. doi: 10.1080/24694193.2018.1520323. Epub 2018 Sep 25.
Improvements in devices and techniques used to provide life support for patients at intensive care units have reduced patient mortality. Increases in the number of survivors from a critical illness have brought long-term complications experienced during the post-intensive care period into question. The term post-intensive care syndrome (PICS) is defined as a new and deteriorating disorder in the cognitive, mental, and physical health status experienced by the survivor after intensive care unit discharge that might continue for months or even years. Opioid and sedation exposure, the severity of illnesses and injuries, dense life support interventions, length of stay in the intensive care unit, and social isolation constitute risk factors for PICS in children. These factors cause the child to experience deterioration in physical, cognitive, and psychological health domains. Such deteriorations occur on various levels and have negative effects on quality of life. The purpose of this article is to raise awareness and help pediatric nurses to develop an understanding of the condition. Increasing awareness by pediatric nurses about the magnitude and effects of complications after discharge from the intensive care unit will be the first step to protect survivors from new problems, to provide assistance for ongoing problems, and to develop follow-up strategies. PICS-related morbidities affect the majority of children discharged from PICUs. We need to understand the scope of those morbidities and develop efficient nursing interventions accordingly. It is time to expand our goal for critical and noncritical care from life-saving into improvement of functional health status and quality of life.
重症监护病房中用于为患者提供生命支持的设备和技术的改进降低了患者死亡率。危重病幸存者数量的增加使得重症监护后期出现的长期并发症受到质疑。“重症监护后综合征”（PICS）这一术语被定义为重症监护病房出院后的幸存者在认知、心理和身体健康状况方面出现的一种新的且不断恶化的病症，这种病症可能会持续数月甚至数年。阿片类药物和镇静剂的使用、疾病和损伤的严重程度、密集的生命支持干预、在重症监护病房的住院时间以及社会隔离是儿童发生PICS的危险因素。这些因素导致儿童在身体、认知和心理健康领域出现恶化。这种恶化在不同层面发生，并对生活质量产生负面影响。本文的目的是提高认识，并帮助儿科护士了解这种情况。提高儿科护士对重症监护病房出院后并发症的严重程度和影响的认识，将是保护幸存者免受新问题困扰、为持续存在的问题提供帮助以及制定后续策略的第一步。与PICS相关的发病率影响了大多数从儿科重症监护病房出院的儿童。我们需要了解这些发病率的范围，并相应地制定有效的护理干预措施。现在是时候将我们对重症和非重症护理的目标从挽救生命扩大到改善功能健康状况和生活质量了。
