The current situation and the effect factors of post-intensive care syndrome among patients in RICU_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHOU Meng , CHEN Liquan , JIN Xue , JIA Na , LI Li , SHEN Yan'e ,  ZHANG Jianxia

Peking University First Hospital, Beijing 100034, P. R. China;

Corresponding author：

ZHANG Jianxia, Email: zhangjianxia2003@126.com

Keywords：

Post-intensive care syndrome; Intensive care unit; Incidence; Effect factors

DOI：

10.7507/1671-6205.201901039

Video：

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Objective To survey the current situation of post-intensive care syndrome (PICS) among patients in respiratory intensive careunit (RICU), and explore the effect factors of PICS.Methods By convenience sampling, 125 patients in the RICU of Peking University First Hospital were recruited in the study. The patients were tested for PICS using Mini-mental State Examination (MMSE), Confusion Assessment Method for the ICU (CAM-ICU), Hospital Anxiety and Depression Scale (HADS), Medical Research Council (MRC), Activities of Daily Living (ADL), Pittsburg Sleep Quality Index (PSQI), Fatigue Scale-14 (FS-14), including three aspects of cognition, psychology and physiology. The effect factors of PICS were measured through researcher-created Questionnaire on Patients’ General Information and Questionnaire on Disease-Related Information.Results In this study, the actual effective sample size was 110 cases, among which 59 cases developed PICS, with an incidence of 53.6%. Logistic regression showed that effect factors of PICS were age, invasive mechanical ventilation time, noninvasive ventilator assisted ventilation time and coronary atherosclerotic heart disease (P< 0.05).Conclusions The incidence of PICS in RICU patients is 53.6%, which is at a high level. Advanced age, long duration of invasive mechanical ventilation, long duration of non-invasive ventilator assisted ventilation, and coronary atherosclerotic heart disease are the risk factors of PICS. Medical and nursing staff should pay more attention to PICS, intervene in the risk factors of the patient, and take targeted measures to prevent the occurrence of PICS.

Citation： ZHOU Meng, CHEN Liquan, JIN Xue, JIA Na, LI Li, SHEN Yan'e, ZHANG Jianxia. The current situation and the effect factors of post-intensive care syndrome among patients in RICU. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(1): 53-58. doi: 10.7507/1671-6205.201901039 Copy

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2.	魏春莲, 廖莲清, 刘沛仪, 等. ICU 转出过渡护理在重度 COPD 患者转至呼吸内科中的应用效果. 护士进修杂志, 2015, 30(12): 1103-1105.
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6.	Locke M, Eccleston S, Ryan CN, et al. Developing a diary program to minimize patient and family post-intensive care syndrome. AACN Adv Crit Care, 2016, 27(2): 212-220.
7.	叶小健, 庄一渝, 陈香萍, 等. ICU 后综合征的干预研究现状. 中华护理杂志, 2015, 50(11): 1369-1374.
8.	韦秀霞, 张秀伟, 彭剑英, 等. 国外 ICU 后综合征的研究现状. 中华护理杂志, 2016, 51(1): 84-89.
9.	Hopkins RO, Mitchell L, Thomsen GE, et al. Implementing a mobility program to minimize post-intensive care syndrome. AACN Adv Crit Care, 2016, 27(2): 187-203.
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11.	敖漫, 敖薪. ICU 后综合征评估工具的研究进展. 护理管理杂志, 2018, 18(2): 107-111.
12.	Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA, 2001, 286(21): 2703-2710.
13.	周小炫. 中文版简易智能精神状态检查量表在脑卒中患者中的信效度初步研究[D]. 福建: 福建中医药大学, 2015: 1-32.
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15.	路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析. 重庆医学, 2014, 43(3): 260-263.
16.	王天芳, 张翠珍, 刘雁峰, 等. 慢性疲劳综合征病人的疲劳、抑郁、焦虑及生活事件的特点及其间相关性分析. 中国行为医学科学杂志, 2000, 9(2): 84-86.
17.	van der Schaaf M, Dettling DS, Beelen A, et al. Poor functional status immediately after discharge from an intensive care unit. Disabil Rehabil, 2008, 30(23): 1812-1818.
18.	Fletcher SN, Kennedy DD, Ghosh IR, et al. Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med, 2003, 31(4): 1012-1016.
19.	McKinley S, Fien M, Elliott R, et al. Sleep and psychological health during early recovery from critical illness: an observational study. J Psychosom Res, 2013, 75(6): 539-545.
20.	Davydow DS, Desai SV, Needham DM, et al. Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med, 2008, 70(4): 512-519.
21.	Mikkelsen ME, Christie JD, Lanken PN, et al. The adult respiratory distress syndrome cognitive outcomes study: long-term neuropsychological function in survivors of acute lung injury. Am J Respir Crit Care Med, 2012, 185(12): 1307-1315.
22.	Barr J, Fraser GL, Puntillo K, et al. Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in adult Patients in the Intensive Care Unit. Crit Care Med, 2013, 41(1): 263-306.
23.	Wade DM, Howell DC, Weinman JA, et al. Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Crit Care, 2012, 16(5): R192.
24.	杨瑾, 白亚娟, 王军霞. 人文关怀在神经内科 ICU 后综合征患者中的应用. 中国实用神经疾病杂志, 2018, 21(4): 440-443.
25.	刘筱凌, 秦佳楠, 徐海英. 基于文献计量学的国外 ICU 后综合征研究热点分析. 中华现代护理杂志, 2017, 23(7): 970-973.
26.	高一兵. 老年冠心病人生理心理特点及其对预后的影响. 甘肃医药, 2011, 6(12): 383-384.

1. Wunsch H, Guerra C, Barnato AE, et al. Three-year outcomes for medicare beneficiaries who survive intensive care. JAMA, 2010, 303(9): 849-856.
2. 魏春莲, 廖莲清, 刘沛仪, 等. ICU 转出过渡护理在重度 COPD 患者转至呼吸内科中的应用效果. 护士进修杂志, 2015, 30(12): 1103-1105.
3. 庄一渝, 韦秀霞, 彭剑英, 等. ICU 过渡期护理临床实践与研究进展. 中华护理杂志, 2016, 51(2): 211-215.
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, 2012, 40(2): 502-509.
5. Elliott D, Davidson JE, Harvey MA, et al. Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting. Crit Care Med, 2014, 42(12): 2518-2526.
6. Locke M, Eccleston S, Ryan CN, et al. Developing a diary program to minimize patient and family post-intensive care syndrome. AACN Adv Crit Care, 2016, 27(2): 212-220.
7. 叶小健, 庄一渝, 陈香萍, 等. ICU 后综合征的干预研究现状. 中华护理杂志, 2015, 50(11): 1369-1374.
8. 韦秀霞, 张秀伟, 彭剑英, 等. 国外 ICU 后综合征的研究现状. 中华护理杂志, 2016, 51(1): 84-89.
9. Hopkins RO, Mitchell L, Thomsen GE, et al. Implementing a mobility program to minimize post-intensive care syndrome. AACN Adv Crit Care, 2016, 27(2): 187-203.
10. 裴倩倩, 王旭东, 李晶, 等. 多学科合作式过渡期护理在ICU后综合征预防中的应用. 护理实践与研究, 2017, 14(5): 36-37.
11. 敖漫, 敖薪. ICU 后综合征评估工具的研究进展. 护理管理杂志, 2018, 18(2): 107-111.
12. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA, 2001, 286(21): 2703-2710.
13. 周小炫. 中文版简易智能精神状态检查量表在脑卒中患者中的信效度初步研究[D]. 福建: 福建中医药大学, 2015: 1-32.
14. 孙军连. 医患焦虑抑郁状况的评价及其对医院满意度的影响[D]. 山西: 山西医科大学第三医院, 2011: 1-5.
15. 路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析. 重庆医学, 2014, 43(3): 260-263.
16. 王天芳, 张翠珍, 刘雁峰, 等. 慢性疲劳综合征病人的疲劳、抑郁、焦虑及生活事件的特点及其间相关性分析. 中国行为医学科学杂志, 2000, 9(2): 84-86.
17. van der Schaaf M, Dettling DS, Beelen A, et al. Poor functional status immediately after discharge from an intensive care unit. Disabil Rehabil, 2008, 30(23): 1812-1818.
18. Fletcher SN, Kennedy DD, Ghosh IR, et al. Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med, 2003, 31(4): 1012-1016.
19. McKinley S, Fien M, Elliott R, et al. Sleep and psychological health during early recovery from critical illness: an observational study. J Psychosom Res, 2013, 75(6): 539-545.
20. Davydow DS, Desai SV, Needham DM, et al. Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med, 2008, 70(4): 512-519.
21. Mikkelsen ME, Christie JD, Lanken PN, et al. The adult respiratory distress syndrome cognitive outcomes study: long-term neuropsychological function in survivors of acute lung injury. Am J Respir Crit Care Med, 2012, 185(12): 1307-1315.
22. Barr J, Fraser GL, Puntillo K, et al. Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in adult Patients in the Intensive Care Unit. Crit Care Med, 2013, 41(1): 263-306.
23. Wade DM, Howell DC, Weinman JA, et al. Investigating risk factors for psychological morbidity three months after intensive care: a prospective cohort study. Crit Care, 2012, 16(5): R192.
24. 杨瑾, 白亚娟, 王军霞. 人文关怀在神经内科 ICU 后综合征患者中的应用. 中国实用神经疾病杂志, 2018, 21(4): 440-443.
25. 刘筱凌, 秦佳楠, 徐海英. 基于文献计量学的国外 ICU 后综合征研究热点分析. 中华现代护理杂志, 2017, 23(7): 970-973.
26. 高一兵. 老年冠心病人生理心理特点及其对预后的影响. 甘肃医药, 2011, 6(12): 383-384.

Chinese Journal of Respiratory and Critical Care Medicine

The current situation and the effect factors of post-intensive care syndrome among patients in RICU

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