Centre for Perioperative Medicine, Division of Surgery & Interventional Science.
Bloomsbury Institute for Intensive Care Medicine, Division of Medicine, UCL, UK.
Curr Opin Crit Care. 2021 Aug 1;27(4):390-398. doi: 10.1097/MCC.0000000000000843.
Addressing the reduced quality of life that affects ICU survivors is the most pressing challenge in critical care medicine. In order to meet this challenge, we must translate lessons learnt from assessing and training athletes to the clinical population, utilizing measurable and targeted parameters obtained during cardiopulmonary exercise testing (CPET).
Critical illness survivors demonstrate a persistent reduction in their physical and metabolic function. This manifests in reduced aerobic exercise capacity and metabolic inflexibility. CPET-guided targeted metabolic conditioning has proved beneficial in several clinical populations, including those undergoing high-risk surgery, and could be successfully applied to the rehabilitation of ICU survivors.
CPET shows great promise in the guidance of rehabilitation in functionally limited ICU survivors. Parallels in the physiological response to exercise in athletes and clinical populations with the stress and consequences of critical illness must be investigated and ultimately applied to the burgeoning population of ICU survivors in order to treat the consequences of survival from critical illness.
改善影响 ICU 幸存者生活质量的问题是重症医学领域最紧迫的挑战。为了应对这一挑战，我们必须将从评估和训练运动员中获得的经验教训应用于临床人群，利用心肺运动测试（CPET）中获得的可测量和针对性参数。
危重病幸存者表现出持续的身体和代谢功能下降。这表现在有氧运动能力和代谢灵活性降低。CPET 指导下的靶向代谢调理已被证明对多种临床人群有益，包括接受高危手术的人群，并且可以成功应用于 ICU 幸存者的康复。
CPET 在指导功能受限的 ICU 幸存者康复方面具有广阔的前景。必须研究运动员和临床人群在对运动的生理反应方面的相似之处，以及危重病的应激和后果，最终将其应用于不断增加的 ICU 幸存者人群，以治疗危重病后幸存的后果。
