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[麻醉学与重症医学中的个体化治疗]

[Individualized treatment in anesthesiology and intensive care medicine].

作者信息

Sadjadi Mahan, Meersch-Dini Melanie

机构信息

Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Geb. A1, 48149, Münster, Deutschland.

出版信息

Anaesthesiologie. 2023 May;72(5):309-316. doi: 10.1007/s00101-023-01271-7. Epub 2023 Mar 6.

Abstract

BACKGROUND

Individualized medicine uses data on biological characteristics of individual patients in order to tailor treatment planning to their unique constitution. With respect to the practice of anesthesiology and intensive care medicine, it bears the potential to systematize the often complex medical care of critically ill patients and to improve outcomes.

OBJECTIVE

The aim of this narrative review is to provide an overview of the possible applications of the principles of individualized medicine in anesthesiology and intensive care medicine.

MATERIAL AND METHODS

Based on a search in MEDLINE, CENTRAL and Google Scholar, the results of previous studies and systematic reviews are narratively synthesized and the implications for the scientific and clinical practice are presented.

RESULTS AND DISCUSSION

There are possibilities for individualization and an increase in precision of patient care in most if not all problems in anesthesiology and symptoms in intensive medical care. Even now, all practicing physicians can initiate measures to individualize treatment at different timepoints throughout the course of treatment. Individualized medicine can supplement and be integrated into protocols. Plans for future applications of individualized medicine interventions should consider the feasibility in a real-world setting. Clinical studies should contain process evaluations in order to create ideal preconditions for a successful implementation. Quality management, audits and feedback should become a standard procedure to ensure sustainability. In the long run, individualization of care, especially in the critically ill, should be enshrined in guidelines and become an integral part of clinical practice.

摘要

背景

个性化医疗利用个体患者的生物学特征数据,以便根据其独特体质制定治疗方案。对于麻醉学和重症医学实践而言,它有可能使危重症患者通常复杂的医疗护理系统化并改善治疗结果。

目的

本叙述性综述的目的是概述个性化医疗原则在麻醉学和重症医学中的可能应用。

材料与方法

基于对MEDLINE、CENTRAL和谷歌学术的检索,对先前研究和系统评价的结果进行叙述性综合,并阐述其对科学和临床实践的意义。

结果与讨论

在麻醉学的大多数(即便不是全部)问题以及重症医学的症状方面,存在实现患者护理个性化和提高精准度的可能性。即便在当下,所有执业医师都可在治疗过程中的不同时间点采取措施使治疗个性化。个性化医疗可补充并融入治疗方案。个性化医疗干预措施的未来应用计划应考虑现实环境中的可行性。临床研究应包含过程评估,以便为成功实施创造理想条件。质量管理、审核和反馈应成为确保可持续性的标准程序。从长远来看,护理的个性化,尤其是针对危重症患者的护理,应纳入指南并成为临床实践的一个组成部分。

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