Continuum (Minneap Minn). 2020 Jun;26(3):675-694. doi: 10.1212/CON.0000000000000869.
Nervous system tissues have high metabolic demands and other unique vulnerabilities that place them at high risk of injury in the context of critical medical illness. This article describes the neurologic complications that are commonly encountered in patients who are critically ill from medical diseases and presents strategies for their diagnosis, prevention, and treatment.
Chronic neurologic disability is common after critical medical illness and is a major factor in the quality of life for survivors of critical illness. Studies that carefully assessed groups of patients with general critical illness have identified a substantial rate of covert seizures, brain infarcts, muscle wasting, peripheral nerve injuries, and other neurologic sequelae that are strong predictors of poor neurologic outcomes. As the population ages and intensive care survivorship increases, critical illness-related neurologic impairments represent a large and growing proportion of the overall burden of neurologic disease.
Improving critical illness outcomes requires identifying and managing the underlying cause of comorbid neurologic symptoms.
神经系统组织代谢需求高，且存在其他独特的脆弱性，使其在危重疾病状态下极易受到损伤。本文描述了在患有内科疾病的危重患者中常见的神经系统并发症，并介绍了其诊断、预防和治疗策略。
危重疾病后慢性神经功能障碍较为常见，是危重病幸存者生活质量的主要影响因素。对一般危重患者群体进行的精心评估研究发现，隐匿性发作、脑梗死、肌肉萎缩、周围神经损伤和其他神经系统后遗症的发生率较高，这些都是神经结局不良的强预测因素。随着人口老龄化和重症监护存活率的增加，与危重疾病相关的神经系统损伤占神经系统疾病总负担的比例较大且呈增长趋势。
改善危重疾病结局需要确定和治疗合并的神经系统症状的根本原因。
