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基于共识的重症监护后综合征评估建议:一项系统综述

Consensus-Based Recommendations for Assessing Post-Intensive Care Syndrome: A Systematic Review.

作者信息

Bornemann-Cimenti Helmar, Lang Johanna, Hammer Sascha, Lang-Illievich Kordula, Labenbacher Sebastian, Neuwersch-Sommeregger Stefan, Klivinyi Christoph

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, 8010 Graz, Austria.

Department of Anesthesiology, Perioperative Medicine and General Intensive Care Medicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.

出版信息

J Clin Med. 2025 May 21;14(10):3595. doi: 10.3390/jcm14103595.

Abstract

Post-intensive care syndrome encompasses physical, cognitive, and psychological impairments that persist in patients after discharge from an intensive care unit. There is considerable variation in the tools used for assessment. This systematic review aimed to summarize the consensus-based recommendations for assessing post-intensive care syndrome. A comprehensive literature search identified four consensus-based guidelines. A quality assessment carried out using the Appraisal of Guidelines for Research and Evaluation II tool demonstrated high methodological standards across all the included papers. The guidelines consistently emphasize assessing cognition, mental health, and physical function as the core domains. However, there are notable differences in the specific tools recommended. Major et al. focused on physical examinations, while Mikkelsen et al. proposed a fundamental package of five tools covering the key domains. Spies et al. aimed for a pragmatic set of freely available instruments administrable within 30 min. Nakanishi et al. provided a detailed ranking of instruments for each domain. The availability of validated translations varied considerably across languages. Some tools developed specifically for post-intensive care syndrome were not considered by any consensus conference. Further work is needed to establish a universally accepted standard for assessing post-intensive care syndrome that considers practical implementation across diverse settings and languages.

摘要

重症监护后综合征包括重症监护病房出院患者持续存在的身体、认知和心理障碍。评估所使用的工具存在很大差异。本系统评价旨在总结基于共识的重症监护后综合征评估建议。全面的文献检索确定了四项基于共识的指南。使用《研究与评价指南评估II》工具进行的质量评估表明,所有纳入论文的方法学标准都很高。这些指南一致强调将认知、心理健康和身体功能评估作为核心领域。然而,在推荐的具体工具方面存在显著差异。梅杰等人侧重于体格检查,而米凯尔森等人提出了一套涵盖关键领域的五项基本工具。斯皮斯等人的目标是提供一套实用的、可在30分钟内使用的免费工具。中西等人提供了每个领域工具的详细排名。经过验证的翻译在不同语言中的可用性差异很大。一些专门为重症监护后综合征开发的工具未被任何共识会议考虑。需要进一步开展工作,以建立一个普遍接受的重症监护后综合征评估标准,该标准要考虑到在不同环境和语言中的实际应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08b5/12112106/b73c8721b5ac/jcm-14-03595-g001.jpg

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