Medication Management to Ameliorate Post‐Intensive Care Syndrome
Medication Management to Ameliorate Post‐Intensive Care Syndrome
复制标题
改善重症监护后综合症的药物管理
作者：
Earnest Alexander;G. Susla;J. Stollings;S. Bloom;Elizabeth L. Huggins;S. L. Grayson;J. Jackson;C. Sevin
近年来，由于护理的进步，重症患者的M率显着下降。1鉴于重症患者的生存率提高，研究人员将重点从短期死亡率扩大到长期死亡率和发病率，而这些死亡率和发病率往往未被重症监护室（ICU）医生所认识。重症监护医学会（SCCM）已将重症监护后综合征（PICS）定义为在急性住院治疗后持续存在的危重病后精神、认知或身体健康状况的新的或恶化的下降。2许多药物相关风险因素与危重病患者认知功能障碍的发展相关，包括血糖失调、3，4谵妄、5和药物。6药物也与ICU入院后的急性神经肌肉无力相关。7在过去的十年中，在护理过渡期间药物不良事件（ADE）的风险增加已广为人知。本专栏重点介绍ICU中、ICU后和住院后的药物管理策略如何预防或帮助管理PICS。
M rates of critically ill patients have decreased markedly in recent years thanks to advancements in care.1 Given the improved survival rates of critically ill patients, investigators have broadened their focus from short-term mortality to long-term mortality and morbidities that are often underrecognized by intensive care unit (ICU) practitioners. The Society of Critical Care Medicine (SCCM) has defined post–intensive care syndrome (PICS) as a new or worsening decrement in mental, cognitive, or physical health following critical illness that persists beyond the acute hospitalization.2 Many medication-related risk factors are associated with development of cognitive impairment in critically ill patients, including glucose dysregulation,3,4 delirium,5 and medications.6 Medications have also been associated with acute neuromuscular weakness following an ICU admission.7 In the past decade, the increased risk of adverse drug events (ADEs) during transitions of care has become widely known. This column focuses on how medication management strategies in the ICU, after the ICU, and after hospitalization may prevent or help manage PICS.