Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD, United States; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States.
Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States.
Am J Otolaryngol. 2021 May-Jun;42(3):102917. doi: 10.1016/j.amjoto.2021.102917. Epub 2021 Jan 9.
Mortality from COVID-19 has obscured a subtler crisis - the swelling ranks of COVID-19 survivors. After critical illness, patients often suffer post-intensive care syndrome (PICS), which encompasses physical, cognitive, and/or mental health impairments that are often long-lasting barriers to resuming a meaningful life. Some deficits after COVID-19 critical illness will require otolaryngologic expertise for years after hospital discharge. There are roles for all subspecialties in preventing, diagnosing, or treating sequelae of COVID-19. Otolaryngologist leadership in multidisciplinary efforts ensures coordinated care. Timely tracheostomy, when indicated, may shorten the course of intensive care unit stay and thereby potentially reduce the impairments associated with PICS. Otolaryngologists can provide expertise in olfactory disorders; thrombotic sequelae of hearing loss and vertigo; and laryngotracheal injuries that impair speech, voice, swallowing, communication, and breathing. In the aftermath of severe COVID-19, otolaryngologists are poised to lead efforts in early identification and intervention for impairments affecting patients' quality of life.
COVID-19 死亡率掩盖了一个更微妙的危机——COVID-19 幸存者人数的不断增加。在重病后,患者经常患有重症监护后综合征(PICS),这包括身体、认知和/或心理健康受损,这些通常是恢复有意义生活的长期障碍。COVID-19 危重病后,一些缺陷需要在出院后多年接受耳鼻喉科专业知识。所有亚专业都可以在预防、诊断或治疗 COVID-19 的后遗症方面发挥作用。耳鼻喉科医生在多学科努力中的领导地位确保了协调的护理。在需要时及时进行气管切开术,可能会缩短重症监护病房的住院时间,从而减少与 PICS 相关的损伤。耳鼻喉科医生可以提供嗅觉障碍方面的专业知识;听力损失和眩晕的血栓后遗症;以及影响言语、声音、吞咽、沟通和呼吸的喉气管损伤。在严重 COVID-19 之后,耳鼻喉科医生有望在影响患者生活质量的损伤的早期识别和干预方面发挥主导作用。