What Follows Survival of Critical Illness? Physical Therapists' Management of Patients With Post-Intensive Care Syndrome
What Follows Survival of Critical Illness? Physical Therapists' Management of Patients With Post-Intensive Care Syndrome
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DOI：
10.2522/ptj.20110429
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发表时间：
2013-02-01
期刊：
影响因子：
3.2
通讯作者：
Smith, James M.
中科院分区：
文献类型：
--
作者：
Bemis-Dougherty, Anita R.;Smith, James M.
从历史上看，重症监护病房（ICU）患者的管理包括固定和镇静，护理重点是生理损伤和生存。由于现在有更多的ICU患者能够在住院期间存活下来，因此必须以长期健康、健康和功能为目标来管理他们的ICU护理。证据证实，在ICU中动员和锻炼是可行的，并表明早期动员的好处包括减少在ICU和医院的住院时间。2010年，重症医学学会（SCCM）邀请包括美国物理治疗协会（APTA）在内的主要利益相关者团体确定改善ICU出院后长期后果的策略，包括ICU的早期动员和物理治疗师作为ICU团队成员的整合。这种模式在一些机构中似乎是成功的，但各机构之间存在差异。SCCM特别工作组制定了需要多学科行动的主要重点领域，以改善ICU出院后的长期预后。本文描述了物理治疗师在ICU幸存者管理中的实践，ICU出院后长期随访的重要性，以及APTA如何采取措施解决SCCM工作组确定的主要重点领域，以改善ICU出院后的长期结果。
Historically, the management of patients in the intensive care unit (ICU) has involved immobilization and sedation, with care focused on physiological impairments and survival. Because more ICU patients are now surviving their hospital stay, it is imperative that their ICU care be managed with the goal of long-term health, wellness, and functioning. The evidence confirms that mobilization and exercise are feasible in the ICU and demonstrates that the benefits of early mobilization include reduced length of stay in the ICU and hospital. In 2010, the Society of Critical Care Medicine (SCCM) invited key stakeholder groups, including the American Physical Therapy Association (APTA), to identify strategies to improve long-term consequences following ICU discharge, including early mobilization in the ICU and integration of the physical therapist as a member of the ICU team. This model appears to be successful in some institutions, but there is variation among institutions. The SCCM Task Force developed major areas of focus that require multidisciplinary action to improve long-term outcomes after discharge from an ICU. This article describes physical therapist practice in the management of ICU survivors, the importance of long-term follow-up after ICU discharge, and how APTA is taking steps to address the major areas of focus identified by the SCCM Task Force to improve long-term outcomes after ICU discharge.