Post-Intensive-Care-Syndrom: Risikofaktoren, Prävention und Nachsorge

Langzeitfolgen nach einem Aufenthalt auf der Intensivstation werden unter dem Fachbegriff Post-Intensive-Care-Syndrom (PICS) zusammengefasst. Ein Großteil der Intensivpatient*innen und viele Angehörige sind von den lebensverändernden Folgen einer kritischen Erkrankung betroffen. In diesem Beitrag wird auf die Pathogenese, Langzeitfolgen für Patient*innen sowie präventive und therapeutische Ansätze der Intensivmedizin und -pflege eingegangen.

Schlüsselwörter

PICS - PICS-F - Langzeitfolgen - Prävention - Nachsorge

• Literatur

• 1 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 2012; 40: 502-509
• 2 Brown SM, Bose S, Banner-Goodspeed V. et al. Approaches to Addressing Post-Intensive Care Syndrome among Intensive Care Unit Survivors. A Narrative Review. Ann Am Thorac Soc 2019; 16: 947-956
• 3 Lee M, Kang J, Jeong YJ. Risk factors for post-intensive care syndrome: A systematic review and meta-analysis. Aust Crit Care 2020; 33: 287-294
• 4 Hiser SL, Fatima A, Ali M. et al. Post-intensive care syndrome (PICS): recent updates. J Intensive Care 2023; 11: 23
• 5 Hashem MD, Hopkins RO, Colantuoni E. et al. Six-month and 12-month patient outcomes based on inflammatory subphenotypes in sepsis-associated ARDS: secondary analysis of SAILS-ALTOS trial. Thorax 2022; 77: 22-30
• 6 Brummel NE, Hughes CG, Thompson JL. et al. Inflammation and Coagulation during Critical Illness and Long-Term Cognitive Impairment and Disability. Am J Respir Crit Care Med 2021; 203: 699-706
• 7 Dai H, Liu X, Feng D. et al. Evidence-based nursing combined with cognitive function training can reduce the incidence of delirium in ICU patients and improve their cognitive function. Am J Transl Res 2021; 13: 3262-3269
• 8 Devlin JW, Skrobik Y, Gélinas C. et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med 2018; 46: e825-e873
• 9 Kotfis K, van I Diem-Zaal, Williams Roberson S. et al. The future of intensive care: delirium should no longer be an issue. Crit Care 2022; 26: 200
• 10 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 2019; 47: 3-14
• 11 Mantziou V, Vrettou CS, Vassiliou AG. et al. Family Burden of ICU Survivors and Correlations with Patient Quality of Life and Psychometric Scores – A Pilot Study. J Crit Care Med (Targu Mures) 2022; 8: 242-248
• 12 De Jong A, Kentish N, Souppart V. et al. Post-intensive Care Syndrome in Relatives of Critically Ill Patients. In: Preiser J-C, Herridge M, Azoulay E. Post-Intensive Care Syndrome. Cham: Springer; 2020: 247-259
• 13 Khandelwal N, Hough CL, Downey L. et al. Prevalence, Risk Factors, and Outcomes of Financial Stress in Survivors of Critical Illness. Crit Care Med 2018; 46: e530-e539
• 14 Marra A, Pandharipande PP, Girard TD. et al. Co-Occurrence of Post-Intensive Care Syndrome Problems Among 406 Survivors of Critical Illness. Crit Care Med 2018; 46: 1393-1401
• 15 Rousseau AF, Prescott HC, Brett SJ. et al. Long-term outcomes after critical illness: recent insights. Crit Care 2021; 25: 108
• 16 Mikkelsen M, Netzer G, Iwashyna T. UpToDate: Post-intensive care syndrome (PICS) in adults: Clinical features and diagnostic evaluation. In Manaker S, Finlay G (eds.) UpToDate 2023. Accessed November 03, 2023 at: https://medilib.ir/uptodate/show/88330
• 17 Herridge MS, Tansey CM, Matté A. et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364: 1293-1304
• 18 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 2019; 47: 1497-1504
• 19 Rosa RG, Ferreira GE, Viola TW. et al. Effects of post-ICU follow-up on subject outcomes: A systematic review and meta-analysis. J Crit Care 2019; 52: 115-125
• 20 Ewens BA, Hendricks JM, Sundin D. Surviving ICU: Stories of recovery. J Adv Nurs 2018; 74: 1554-1563
• 21 Emsden C, Hunziker-Schütz S. PICS – Welche Nachsorge benötigen Betroffene?. intensiv 2023; 32: 238-245