Mateo Rodríguez Eva, Puchades Gimeno Francesc, Ezzeddine Angulo Aida, Asensio Samper Juan, Saiz Ruiz Cristina, López Alarcón María Dolores
UCI de Anestesia, Servicio de Anestesiología, Consorci Hospital General Universitari de València, Valencia, Spain.
Servicio de Medicina Interna, Consorci Hospital General Universitari de València, Valencia, Spain.
Med Clin (Engl Ed). 2022 Oct 7;159(7):321-326. doi: 10.1016/j.medcle.2021.11.013. Epub 2022 Sep 5.
Postintensive care syndrome (PICS) is the physical, cognitive or psychiatric deterioration that appears after a critical illness and persists beyond hospital admission. The objective of this study was to describe the prevalence of PICS in the patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit of the Consorcio Hospital General Universitario de Valencia.
They benefited from a standardized assessment, addressing health-related quality of life (EuroQol-5D-3L), a physical status (6 MWT, "test up and go" and hand dynamometer), a nutritional assessment (MUST and the Global Subjective Assessment), cognitive impairment (MoCA), mental health disorders (HADS and Davidson Trauma Scale) and pain (visual analogue scale and DN4).
From March to June 2020, 59 patients with SARS-CoV-2 were admitted to our ICU. 29 of these were recruited for the study. The stay in the ICU and the mechanical ventilation time were long (24 days [IQR 12-36], and 18 days [IQR 7-31] respectively). The SOFA upon admission to the ICU was high (3 [IQR 3-5]). Tracheostomy was performed in 52% and pronation in 93%. 90% had some abnormal test. 20% had post-traumatic stress syndrome.
We found that 9 out of 10 survivors of SARS-CoV-2 admitted had at least one PICS alteration at 4-6 weeks from discharge from the Hospital. Six out of 19 patients presented with two or more affected evaluated areas.
重症监护后综合征（PICS）是危重病后出现并持续至出院后的身体、认知或精神衰退。本研究的目的是描述入住巴伦西亚大学综合医院重症监护病房的2019冠状病毒病（COVID-19）患者中PICS的患病率。
他们接受了标准化评估，涉及健康相关生活质量（欧洲五维健康量表-5D-3L）、身体状况（6分钟步行试验、“起立-行走”试验和握力计）、营养评估（营养不良通用筛查工具和整体主观评估）、认知障碍（蒙特利尔认知评估量表）、心理健康障碍（医院焦虑抑郁量表和戴维森创伤量表）以及疼痛（视觉模拟量表和DN4）。
2020年3月至6月，59例感染严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的患者入住我们的重症监护病房。其中29例被纳入研究。在重症监护病房的住院时间和机械通气时间都很长（分别为24天[四分位间距12 - 36]和18天[四分位间距7 - 31]）。入住重症监护病房时的序贯器官衰竭评估（SOFA）评分很高（3[四分位间距3 - 5]）。52%的患者进行了气管切开术，93%的患者进行了俯卧位通气。90%的患者有某项检查异常。20%的患者患有创伤后应激综合征。
我们发现，SARS-CoV-2感染幸存者中，十分之九在出院4至6周时至少有一项PICS改变。19例患者中有6例出现两个或更多受影响的评估领域。
