アブストラクト
| Title | PICSとは何か |
|---|---|
| Subtitle | 特集 「集中治療後症候群 (PICS) - 重症患者・周術期患者の長期予後改善をめざして -」 |
| Authors | 井上茂亮 |
| Authors (kana) | |
| Organization | 神戸大学大学院医学研究科外科系講座災害・救急医学分野 |
| Journal | 外科と代謝・栄養 |
| Volume | 57 |
| Number | 2 |
| Page | 43-47 |
| Year/Month | 2023 / 4 |
| Article | 報告 |
| Publisher | 日本外科代謝栄養学会 |
| Abstract | 集中治療室(ICU)における機器の技術革新やガイドラインによる診療レベルの向上と標準化, 教育プログラムの充実により, 近年の重症患者の生命予後は劇的に改善した. しかしながら, 重症患者の長期予後や生活の質はいまだ改善せず, 集中治療を受けた患者の多くは身体的および精神的な障害を抱えたまま, 十分な社会復帰に至っていない. 集中治療後症候群(Post-intensive care syndrome; PICS)は世界中で急速に進行する超高齢社会とICU患者の高齢化を背景に浮かび上がった21世紀の集中治療医学の新たな問題点である. PICSとは, ICU在室中あるいはICU退室後, さらには退院後に生じる身体機能・認知機能・精神の障害で, ICU患者の長期予後のみならず患者家族の精神にも影響を及ぼすものとして広く認識されはじめている. PICSの提唱からちょうど10年たった今, 本章ではPICSの病態の概要とともに, ABCDEFバンドルを中心とした予防・治療に関する最新の知見を解説し, ICU患者の長期予後改善に向けた方策を提案する. |
| Practice | 臨床医学：外科系 |
| Keywords | PICS, 集中治療後症候群, 身体機能障害, 精神障害, 認知機能障害 |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Rudd KE, Johnson SC, Agesa KM et al.: Global, regional, and national sepsis incidence and mortality, 1990-2017 : analysis for the Global Burden of Disease Study. Lancet 395 : 200-211, 2020
- 2) Zhang Z, Spieth PM, Chiumello D et al.: Declining Mor-tality in Patients With Acute Respiratory Distress Syn-drome : An Analysis of the Acute Respiratory Distress Syndrome Network Trials. Crit Care Med 47 : 315-323, 2019
- 3) Inoue S, Hatakeyama J, Kondo Y et al.: Post-intensive care syndrome : its pathophysiology, prevention, and fu-ture directions. Acute Med Surg 6 : 233-246, 2019
- 4) Needham DM, Davidson J, Cohen H et al.: Improving long-term outcomes after discharge from intensive care unit : report from a stakeholders'conference. Crit Care Med 40 : 502-509, 2012
- 5) Egi M, Ogura H, Yatabe T et al.: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020(J-SSCG 2020). J Intensive Care 9 : 53, 2021
残りの23件を表示する
- 6) Evans L, Rhodes A, Alhazzani W et al.: Surviving sepsis campaign : international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 47 : 1181-1247, 2021
- 7) Kawakami D, Fujitani S, Morimoto T et al.: Prevalence of post-intensive care syndrome among Japanese inten-sive care unit patients : a prospective, multicenter, obser-vational J-PICS study. Crit Care 25 : 69, 2021
- 8) Inoue S, Nakanishi N, Sugiyama J et al.: Prevalence and Long-Term Prognosis of Post-Intensive Care Syndrome after Sepsis : A Single-Center Prospective Observational Study. J Clin Med 11 : 5257, 2022
- 9) Martillo M, Dangayach N, Tabacof L et al.: Postintensive Care Syndrome in Survivors of Critical Illness Related to Coronavirus Disease 2019 : Cohort Study From a New York City Critical Care Recovery Clinic. Crit Care Med 49 : 1427-1438, 2021
- 10) Writing Committee for the CSG, Morin L, Savale L et al.: Four-Month Clinical Status of a Cohort of Patients After Hospitalization for COVID-19. JAMA 325 : 1525-1534, 2021
- 11) Hirshberg EL, Wilson EL, Stanfield V et al.: Impact of Critical Illness on Resource Utilization : A Comparison of Use in the Year Before and After ICU Admission. Crit Care Med 47 : 1497-1504, 2019
- 12) Kamdar BB, Suri R, Suchyta MR et al.: Return to work after critical illness : a systematic review and meta-analy-sis. Thorax 75 : 17-27, 2020
- 13) Khandelwal N, Hough CL, Downey L et al.: Prevalence, Risk Factors, and Outcomes of Financial Stress in Survi-vors of Critical Illness. Crit Care Med 46 : e530-e539, 2018
- 14) Marra A, Pandharipande PP, Girard TD et al.: Co-Occur-rence of Post-Intensive Care Syndrome Problems Among 406 Survivors of Critical Illness. Crit Care Med 46 : 1393-1401, 2018
- 15) Parry SM, Nalamalapu SR, Nunna K et al.: Six-Minute Walk Distance After Critical Illness : A Systematic Re-view and Meta-Analysis. J Intensive Care Med 36 : 343-351, 2021
- 16) Van Aerde N, Meersseman P, Debaveye Y et al.: Five-year impact of ICU-acquired neuromuscular complica-tions : a prospective, observational study. Intensive Care Med 46 : 1184-1193, 2020
- 17) Puthucheary ZA, Gensichen JS, Cakiroglu AS et al.: Im-plications for post critical illness trial design : sub-pheno-typing trajectories of functional recovery among sepsis survivors. Crit Care 24 : 577, 2020
- 18) Fernandez-Gonzalo S, Navarra-Ventura G, Bacardit N et al.: Cognitive phenotypes 1 month after ICU discharge in mechanically ventilated patients : a prospective obser-vational cohort study. Crit Care 24 : 618, 2020
- 19) Unoki T, Sakuramoto H, Uemura S et al.: Prevalence of and risk factors for post-intensive care syndrome : Multi-center study of patients living at home after treatment in 12 Japanese intensive care units, SMAP-HoPe study. PLoS One 16 : e0252167, 2021
- 20) Tripathy S, Acharya SP, Singh S et al.: Post traumatic stress symptoms, anxiety, and depression in patients after intensive care unit discharge-a longitudinal cohort study from a LMIC tertiary care centre. BMC Psychiatry 20 : 220, 2020
- 21) Boede M, Gensichen JS, Jackson JC et al.: Trajectories of depression in sepsis survivors : an observational co-hort study. Crit Care 25 : 161, 2021
- 22) Harlan EA, Miller J, Costa DK et al.: Emotional Experi-ences and Coping Strategies of Family Members of Criti-cally Ill Patients. Chest 158 : 1464-1472, 2020
- 23) Wintermann GB, Petrowski K, Weidner K et al.: Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners : age matters. Crit Care 23 : 39, 2019
- 24) Zante B, Camenisch SA, Schefold JC : Interventions in Post-Intensive Care Syndrome-Family : A Systematic Literature Review. Crit Care Med 48 : e835-e840, 2020
- 25) Nakanishi N, Liu K, Kawakami D et al.: Post-Intensive Care Syndrome and Its New Challenges in Coronavirus Disease 2019(COVID-19) Pandemic : A Review of Re-cent Advances and Perspectives. J Clin Med 10 : 3870, 2021
- 26) Pun BT, Balas MC, Barnes-Daly MA et al.: Caring for Critically Ill Patients with the ABCDEF Bundle : Results of the ICU Liberation Collaborative in Over 15,000 Adults. Crit Care Med 47 : 3-14, 2019
- 27) Wang H, Ji X, Wang AY et al.: Epidemiology of Sepsis-Associated Acute Kidney Injury in Beijing, China : A De-scriptive Analysis. Int J Gen Med 14 : 5631-5649, 2021
- 28) Hsieh SJ, Otusanya O, Gershengorn HB et al.: Staged Implementation of Awakening and Breathing, Coordina-tion, Delirium Monitoring and Management, and Early Mobilization Bundle Improves Patient Outcomes and Re-duces Hospital Costs. Crit Care Med 47 : 885-893, 2019
