As the treatment options,modalities and technology has grown,mortality in intensive care unit(ICU)has been on the decline.More and more patients are being discharged to wards and in the care of their loved ones after ...As the treatment options,modalities and technology has grown,mortality in intensive care unit(ICU)has been on the decline.More and more patients are being discharged to wards and in the care of their loved ones after at times prolonged treatment,sometimes in isolation.These survivors have a lower life expectancy and a poorer quality of life.They can have substantial familial financial implications and an economic impact on the healthcare system in terms of increased and continued utilisation of services,the so-called post intensive care syndrome(PICS).But it is not only the patient who is the sufferer.The mental health of the loved ones and family members may also be affected,which is termed as PICS-family.In this review,we shall be reviewing the definition,epidemiology,clinical features,diagnosis and evaluation,treatment and follow up of PICS.We shall also focus on measures to prevent,rehabilitate and understand the ICU stay from patients’perspective on how to redesign the ICU,post ICU care needs for a better patient outcome.展开更多
AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, ne...AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric population is imperative for designing interventions to improve long-term outcomes in PICU patients.展开更多
目的系统评价严重创伤患者发重症监护后综合征(PICS)的危险因素。方法计算机检索PubMed、Medline、Web of Science、CochraneLibrary、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库中关于严重创伤患者发生PICS危险...目的系统评价严重创伤患者发重症监护后综合征(PICS)的危险因素。方法计算机检索PubMed、Medline、Web of Science、CochraneLibrary、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库中关于严重创伤患者发生PICS危险因素的相关文献,检索时间限定为2010年1月至2024年4月。由2名研究者独立进行文献的筛选与数据提取,采用纽卡斯尔-渥太华量表(NOS)对纳入的队列研究和病例对照研究进行文献质量评价,横断面研究则参照美国卫生保健和质量机构(AHRQ)的标准进行文献质量评价,采用RevMan 5.4和Stata18.0软件进行meta分析。结果共纳入11篇文献,其中7篇为横断面研究,4篇为病例对照研究,文献质量均为中高等。meta分析结果显示,年龄≥60岁(OR=1.66,95%CI:1.43~1.91,P<0.001)、吸烟(OR=5.45,95%CI:1.61~18.47,P=0.006)、饮酒(OR=6.90,95%CI:2.14~22.26,P=0.001)、入住ICU时长≥7 d(OR=2.45,95%CI:1.18~5.11,P=0.020)、机械通气治疗(OR=1.96,95%CI:1.04~3.68,P=0.040)、睡眠障碍(OR=2.78,95%CI:1.35~5.73,P=0.005)、镇静药物使用(OR=2.88,95%CI:1.34~6.22,P=0.007)是严重创伤患者发生PICS的独立危险因素。敏感性和发表偏倚分析结果显示,除年龄≥60岁和入住ICU时长≥7 d因素外,其他因素均提示分析结果可靠,存在发表偏倚可能较小。结论严重创伤患者发生ICU后综合征的危险因素众多,临床实践中医护人员应重点关注其高危人群,并对这些风险因素进行及时的评估和干预,以降低重症创伤患者ICU后综合征的发生率,更好地促进患者健康转归。展开更多
目的:梳理家属ICU后综合征相关文献,以界定该概念。方法:以Arksey和O′Malley的范围综述框架为方法学指导,系统检索PubMed、Web of Science、the Cochrane Library等14个中英文数据库,并辅以手工检索,检索时限为2010年1月1日-2023年4月1...目的:梳理家属ICU后综合征相关文献,以界定该概念。方法:以Arksey和O′Malley的范围综述框架为方法学指导,系统检索PubMed、Web of Science、the Cochrane Library等14个中英文数据库,并辅以手工检索,检索时限为2010年1月1日-2023年4月18日。2名研究者独立筛选文献和提取数据。采用内容分析法分析数据,专家会议讨论并确定概念相关内容。结果:纳入13篇文献,经数据分析和专家讨论后确定了家属ICU后综合征的6个概念关键组成部分和描述性定义。结论:本研究初步阐明了家属ICU后综合征的概念,为该概念的发展和测量提供了一定的参考依据。展开更多
目的对国内外ICU后门诊的应用情况进行范围综述。方法以JBI范围综述指南为框架,计算机检索PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统(SinoMed)中的相关研究。检索时...目的对国内外ICU后门诊的应用情况进行范围综述。方法以JBI范围综述指南为框架,计算机检索PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统(SinoMed)中的相关研究。检索时限为建库至2023年11月28日,对纳入文献进行分析和讨论。结果最终纳入12篇文献,其中中文4篇、英文8篇,发表时间为2003-2023年,分析总结了ICU后门诊的接诊对象、随访时间点、干预措施及应用效果。ICU后门诊改善了患者的心理状态和与心理健康相关的生活质量。结论ICU后门诊在延续护理方面发挥重要作用,但缺乏统一的指南和诊疗流程,未来需探讨ICU后门诊的开展模式,为构建符合我国医疗体系的ICU后门诊提供参考。展开更多
目的:分析并阐明重症病人重症监护室(ICU)后综合征概念的定义及其内涵。方法:系统检索中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、Web of Science、EMbase、CINAHL,根据纳入和排除标准选取63篇文献,应用Rodg...目的:分析并阐明重症病人重症监护室(ICU)后综合征概念的定义及其内涵。方法:系统检索中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、Web of Science、EMbase、CINAHL,根据纳入和排除标准选取63篇文献,应用Rodgers概念分析框架,从ICU后综合征概念的演化、概念属性、前因和后果、测量工具及相关概念等方面对ICU后综合征的相关内容进行分析、整合。结果:ICU后综合征包括新发或恶化的多维损伤、身体功能障碍、心理障碍、认知障碍、社会功能障碍、多维功能障碍在ICU转出后持续存在等6个概念属性;先决条件包括ICU相关因素、个人因素和疾病因素;结局包括对病人和家庭的影响。结论:通过概念分析明确了重症病人ICU后综合征的概念属性,未来还需结合我国国情对相关评估工具、影响因素和干预等进行深入研究,从而改善重症病人结局。展开更多
文摘As the treatment options,modalities and technology has grown,mortality in intensive care unit(ICU)has been on the decline.More and more patients are being discharged to wards and in the care of their loved ones after at times prolonged treatment,sometimes in isolation.These survivors have a lower life expectancy and a poorer quality of life.They can have substantial familial financial implications and an economic impact on the healthcare system in terms of increased and continued utilisation of services,the so-called post intensive care syndrome(PICS).But it is not only the patient who is the sufferer.The mental health of the loved ones and family members may also be affected,which is termed as PICS-family.In this review,we shall be reviewing the definition,epidemiology,clinical features,diagnosis and evaluation,treatment and follow up of PICS.We shall also focus on measures to prevent,rehabilitate and understand the ICU stay from patients’perspective on how to redesign the ICU,post ICU care needs for a better patient outcome.
文摘AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric population is imperative for designing interventions to improve long-term outcomes in PICU patients.
文摘目的:梳理家属ICU后综合征相关文献,以界定该概念。方法:以Arksey和O′Malley的范围综述框架为方法学指导,系统检索PubMed、Web of Science、the Cochrane Library等14个中英文数据库,并辅以手工检索,检索时限为2010年1月1日-2023年4月18日。2名研究者独立筛选文献和提取数据。采用内容分析法分析数据,专家会议讨论并确定概念相关内容。结果:纳入13篇文献,经数据分析和专家讨论后确定了家属ICU后综合征的6个概念关键组成部分和描述性定义。结论:本研究初步阐明了家属ICU后综合征的概念,为该概念的发展和测量提供了一定的参考依据。
文摘目的对国内外ICU后门诊的应用情况进行范围综述。方法以JBI范围综述指南为框架,计算机检索PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统(SinoMed)中的相关研究。检索时限为建库至2023年11月28日,对纳入文献进行分析和讨论。结果最终纳入12篇文献,其中中文4篇、英文8篇,发表时间为2003-2023年,分析总结了ICU后门诊的接诊对象、随访时间点、干预措施及应用效果。ICU后门诊改善了患者的心理状态和与心理健康相关的生活质量。结论ICU后门诊在延续护理方面发挥重要作用,但缺乏统一的指南和诊疗流程,未来需探讨ICU后门诊的开展模式,为构建符合我国医疗体系的ICU后门诊提供参考。
文摘目的:分析并阐明重症病人重症监护室(ICU)后综合征概念的定义及其内涵。方法:系统检索中国知网、万方数据库、维普数据库、中国生物医学文献服务系统、PubMed、Web of Science、EMbase、CINAHL,根据纳入和排除标准选取63篇文献,应用Rodgers概念分析框架,从ICU后综合征概念的演化、概念属性、前因和后果、测量工具及相关概念等方面对ICU后综合征的相关内容进行分析、整合。结果:ICU后综合征包括新发或恶化的多维损伤、身体功能障碍、心理障碍、认知障碍、社会功能障碍、多维功能障碍在ICU转出后持续存在等6个概念属性;先决条件包括ICU相关因素、个人因素和疾病因素;结局包括对病人和家庭的影响。结论:通过概念分析明确了重症病人ICU后综合征的概念属性,未来还需结合我国国情对相关评估工具、影响因素和干预等进行深入研究,从而改善重症病人结局。
