Weber R J, Oszko M A, Bolender B J, Grysiak D L
Drug Intell Clin Pharm. 1985 Jan;19(1):13-20. doi: 10.1177/106002808501900103.
The psychological assessment and management of the critically ill patient is often overlooked as a part of the patient care plan. The intensive care unit (ICU) syndrome is a type of organic brain syndrome manifested by a variety of psychological reactions, including fear, anxiety, depression, hallucinations, and delirium. Causes, treatment modalities, and a multidisciplinary approach to preventing the ICU syndrome are presented. Causative factors that should be assessed in the psychological evaluation of ICU patients include: (1) preadmission history; (2) past ability to adapt to stress; (3) past and current medications; (4) current clinical status; and (5) environmental factors. The treatment of the ICU syndrome includes: (1) the correction or elimination of causative factors; (2) the appropriate choice, dose, and route of administration of anxiolytic and antipsychotic agents; (3) reduction or elimination of sources of environmental stress; and (4) frequent patient and family communication. Finally, the prevention of the ICU syndrome through the involvement of physicians, nurses, and pharmacists is stressed.
危重症患者的心理评估与管理常常被忽视，未能成为患者护理计划的一部分。重症监护病房（ICU）综合征是一种器质性脑综合征，表现为多种心理反应，包括恐惧、焦虑、抑郁、幻觉和谵妄。本文介绍了其病因、治疗方式以及预防ICU综合征的多学科方法。在对ICU患者进行心理评估时应评估的致病因素包括：（1）入院前病史；（2）过去适应压力的能力；（3）过去和目前的用药情况；（4）当前临床状况；以及（5）环境因素。ICU综合征的治疗包括：（1）纠正或消除致病因素；（2）合理选择、确定剂量及给药途径使用抗焦虑和抗精神病药物；（3）减少或消除环境压力源；以及（4）频繁与患者和家属沟通。最后，强调通过医生、护士和药剂师的参与来预防ICU综合征。
