2015年6月25日文献精读摘要

作者：TeachingAssistant 来源：日期：2015/7/1 16:58:10 人气：

Am J Respir Crit Care Med. 2015 Jun 15;191(12):1367-73. doi: 10.1164/rccm.201502-0346UP.

Update in Mechanical Ventilation, Sedation, and Outcomes 2014.

Goligher EC1,2,3, Douflé G2, Fan E1,2,4.

Novel approaches to the management of acute respiratory distress syndrome include strategies to enhance alveolar liquid clearance, promote epithelial cell growth and recovery after acute lung injury, and individualize ventilator care on the basis of physiological responses.

Critical illness causes long-term psychological and function sequelae: the risk of a new psychiatric diagnosis and severe physical impairment is significantly increased in the months after discharge from the intensive care unit. These long-term effects might be amenable to changes in sedation practice and increased early mobilization.

Daily sedation discontinuation enhances the validity of routine delirium assessment. Many critically ill patients merit assessment by palliative care clinicians; the demand for palliative care services among critically ill patients is expected to grow.

Future trials to test therapies for critical illness must ensure that study designs are adequately powered to detect benefit using realistic event rates. Integrating "big data" approaches into treatment decisions and trial designs offers a potential means of individualizing care to enhance outcomes for critically ill patients.

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2015年6月25日文献精读摘要

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