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老年重症监护病房患者及其管理:临床挑战。

Elderly Patients and Management in Intensive Care Units (ICU): Clinical Challenges.

机构信息

Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Clin Interv Aging. 2023 Jan 22;18:93-112. doi: 10.2147/CIA.S365968. eCollection 2023.

Abstract

There is a growing population of older adults requiring admission to the intensive care unit (ICU). This population outpaces the ability of clinicians with geriatric training to assist in their management. Specific training and education for intensivists in the care of older patients is valuable to help understand and inform clinical care, as physiologic changes of aging affect each organ system. This review highlights some of these aging processes and discusses clinical implications in the vulnerable older population. Other considerations when caring for these older patients in the ICU include functional outcomes and morbidity, as opposed to merely a focus on mortality. An overall holistic approach incorporating physiology of aging, applying current evidence, and including the patient and their family in care should be used when caring for older adults in the ICU.

摘要

需要入住重症监护病房(ICU)的老年患者人数不断增加。这一人群的增长速度超过了接受老年医学培训的临床医生协助管理的能力。对重症医学医师进行专门的老年患者护理培训和教育是有价值的,可以帮助他们理解和提供临床护理,因为衰老的生理变化会影响每个器官系统。本综述强调了其中一些衰老过程,并讨论了脆弱老年人群中的临床意义。在 ICU 中照顾这些老年患者时,还需要考虑其他因素,如功能结局和发病率,而不仅仅是关注死亡率。在 ICU 中照顾老年患者时,应采用整体方法,结合衰老的生理学,应用现有证据,并让患者及其家属参与护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8b/9879046/0bd180a71bb7/CIA-18-93-g0001.jpg

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