Considerations in caring for the critically ill older patient.
Considerations in caring for the critically ill older patient.
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DOI：
10.1177/0885066608329942
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发表时间：
2009-03-01
影响因子：
3.1
通讯作者：
Pisani, Margaret A
中科院分区：
文献类型：
--
作者：
Pisani, Margaret A
65岁以上的人是人口中增长最快的部分，占美国重症监护病房入院人数的42%至52%。随着年龄的增长，会发生许多生理变化，这些变化会影响老年危重病患者的表现和管理。老年患者发生脓毒症的风险增加，年龄本身会影响脓毒症相关结局。谵妄在老年重症监护室患者中也非常普遍，并与不良结局相关。虽然结局研究表明，在调整疾病严重程度后，实际年龄本身并不是不良结局的风险因素，但老年患者明显存在生理变化，在提供重症监护时需要考虑这些变化。本文将综述衰老的重要生理变化，以及脓毒症和谵妄和老年ICU患者的结局。
People over age 65 are the fastest growing segment of the population and account for 42% to 52% of the intensive care unit admissions in the United States. There are many physiologic changes that occur with aging which can impact on both the presentation and management of older patients with critical illness. Older patients have an increased risk for the development of sepsis, and age itself impacts on outcomes related to sepsis. Delirium is also very prevalent among older intensive care unit patients and is associated with adverse outcomes. While outcome studies suggest that chronologic age itself is not a risk factor for poor outcomes after adjusting for severity of illness, older patients clearly have physiologic changes which need to be considered when providing critical care. This article will review important physiologic changes of aging, as well as sepsis and delirium and outcomes of older ICU patients.