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揭开隐藏的后遗症:重症监护病房后遗症、出院准备和长期随访。

Unmasking the hidden aftermath: postintensive care unit sequelae, discharge preparedness, and long-term follow-up.

机构信息

Department of Internal Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brazil.

Department of Internal Medicine, Hospital Moinhos de Vento - Porto Alegre (RS), Brazil.

出版信息

Crit Care Sci. 2024 Jun 14;36:e20240265en. doi: 10.62675/2965-2774.20240265-en. eCollection 2024.

Abstract

A significant portion of individuals who have experienced critical illness encounter new or exacerbated impairments in their physical, cognitive, or mental health, commonly referred to as postintensive care syndrome. Moreover, those who survive critical illness often face an increased risk of adverse consequences, including infections, major cardiovascular events, readmissions, and elevated mortality rates, during the months following hospitalization. These findings emphasize the critical necessity for effective prevention and management of long-term health deterioration in the critical care environment. Although conclusive evidence from well-designed randomized clinical trials is somewhat limited, potential interventions include strategies such as limiting sedation, early mobilization, maintaining family presence during the intensive care unit stay, implementing multicomponent transition programs (from intensive care unit to ward and from hospital to home), and offering specialized posthospital discharge follow-up. This review seeks to provide a concise summary of recent medical literature concerning long-term outcomes following critical illness and highlight potential approaches for preventing and addressing health decline in critical care survivors.

摘要

相当一部分经历过危重病的人会出现新的或恶化的身体、认知或心理健康方面的损伤,通常称为重症监护后综合征。此外,那些存活下来的危重病患者在住院后的几个月内经常面临更多的不良后果的风险,包括感染、主要心血管事件、再入院和死亡率升高。这些发现强调了在重症监护环境中有效预防和管理长期健康恶化的至关重要性。尽管来自精心设计的随机临床试验的明确证据有些有限,但潜在的干预措施包括限制镇静、早期活动、在重症监护病房期间保持家属陪伴、实施多组分过渡计划(从重症监护病房到病房和从医院到家庭),以及提供专门的出院后随访。这篇综述旨在简要总结最近关于危重病后长期结局的医学文献,并强调预防和解决重症监护幸存者健康下降的潜在方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e365/11152445/a9affba5bbe4/2965-2774-ccsci-36-e20240265en-gf01.jpg

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