Bein T, Karagiannidis C, Gründling M, Quintel M
Fakultät für Medizin, Universität Regensburg, 93042, Regensburg, Deutschland.
Abteilung für Pneumologie und Intensivmedizin, Klinikum Köln-Merheim, ARDS und ECMO Center, Kliniken der Stadt Köln, Witten/Herdecke Universität, 51109, Köln, Deutschland.
Anaesthesist. 2020 Jul;69(7):463-469. doi: 10.1007/s00101-020-00783-w.
In the last five decades a continuous increase in the average global temperature has been recorded. Furthermore, natural disasters (e.g. heat waves, severe storms, floods and large forest fires) are becoming more frequent. The impact of global warming and climate change on health involves an increase in respiratory, cardiovascular, renal and cognitive mental diseases. Furthermore, a change in the frequency and patterns of infectious diseases can also be observed in Europe.
This article presents the most important studies that investigated diseases associated with the climate change, with special reference to those that represent a challenge for intensive care medicine.
Currently available epidemiological data and statistical extrapolations indicate that diseases resulting from the climate change (acute infection-related respiratory and intestinal diseases, exacerbation of pre-existing pulmonary lesions, heat-related dehydration, cerebral insults and myocardial infarction) are relevant for intensive care medicine. Particular emphasis is placed on a significant increase in acute kidney damage during heat waves. A previously unknown pattern of infectious diseases necessitates new knowledge and targeted management. In some studies, persisting mental impairments were registered during heat waves and natural disasters, e.g. posttraumatic stress disorder.
Intensive care medicine must be prepared for the challenges due to global warming and climate change. Slow but continuous changes (e.g. rise in temperature) as well as acute changes (e.g. heat waves and natural disasters) will induce an increased need for intensive medical care services (e.g. an increase in the need for renal replacement procedures). Intensive care physicians will need to be familiar with the diagnostics and management of diseases associated with the climate change. An initiative of the specialist societies involved would be welcomed.
在过去五十年间，全球平均气温持续上升。此外，自然灾害（如热浪、严重风暴、洪水和大型森林火灾）愈发频繁。全球变暖和气候变化对健康的影响包括呼吸道、心血管、肾脏和认知精神疾病的增加。此外，在欧洲也可观察到传染病频率和模式的变化。
本文介绍了调查与气候变化相关疾病的最重要研究，特别提及那些对重症医学构成挑战的研究。
目前可得的流行病学数据和统计推断表明，气候变化导致的疾病（与急性感染相关的呼吸道和肠道疾病、原有肺部病变的加重、热相关脱水、脑损伤和心肌梗死）与重症医学相关。特别强调热浪期间急性肾损伤显著增加。一种此前未知的传染病模式需要新知识和针对性管理。在一些研究中，热浪和自然灾害期间出现了持续的精神障碍，如创伤后应激障碍。
重症医学必须为全球变暖和气候变化带来的挑战做好准备。缓慢但持续的变化（如气温上升）以及急性变化（如热浪和自然灾害）将导致对重症医疗服务的需求增加（如肾脏替代程序需求的增加）。重症医学医生需要熟悉与气候变化相关疾病的诊断和管理。相关专业协会的倡议将受到欢迎。
