A New Era in Critical Care Trials: Linking ICU Practice to Long-Term Outcomes.
A New Era in Critical Care Trials: Linking ICU Practice to Long-Term Outcomes.
复制标题
重症监护试验的新时代：将 ICU 实践与长期结果联系起来。
DOI：
10.1164/rccm.202402-0349ed
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发表时间：
2024
影响因子：
24.7
通讯作者：
Mikkelsen,MarkE
中科院分区：
文献类型：
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作者：
Hippensteel,JosephA;Aggarwal,NeilR;Mikkelsen,MarkE
四分之一世纪前，霍普金斯及其同事发现，在1年时，78%的急性呼吸窘迫综合征（ARDS）幸存者在一个或多个认知领域出现障碍（1）。十年后，“重症监护后综合征”一词被提出（2），生存率被认为是“21世纪世纪重症监护的决定性挑战”（3），研究ICU实践对长期结局的影响对重症监护医学的未来至关重要（4）。认知结果在PILOT（最佳氧气目标的实用调查）研究，由Mart及其同事发表（pp. 861-870）在这一期的杂志，标志着一个新的时代是我们（5）。基于先前的观察性研究，证明了较低的Pa O2与ARDS幸存者的认知功能障碍之间的相关性（1，6），低氧血症和ARDS是公认的ICU后认知功能障碍的风险因素（7）。然而，更高的动脉血氧饱和度（SpO 2）是否能降低长期认知障碍的风险仍是未知数。
A quarter of a century ago, Hopkins and colleagues discovered that, at 1 year, 78% of acute respiratory distress syndrome (ARDS) survivors experienced impairment in one or more cognitive domains (1). A decade later, the term “post–intensive care syndrome” was created (2), survivorship was identified as “the defining challenge of critical care in the 21st century”(3), and the need to examine the impact of ICU practice on long-term outcomes was posited as essential to the future of critical care medicine (4).CO-PILOT, the Cognitive Outcomes in PILOT (Pragmatic Investigation of Optimal Oxygen Targets) study, published by Mart and colleagues (pp. 861–870) in this issue of the Journal, signifies that a new era is upon us (5). Based on prior observational studies that demonstrated an association between lower Pa O 2 and cognitive impairment among ARDS survivors (1, 6), hypoxemia and ARDS are recognized risk factors for post-ICU cognitive impairment (7). Yet, whether higher arterial oxygen saturation (Sp O 2) reduces the risk of long-term cognitive impairment remains largely unknown.