Evidencia sobre estrategias de prevención y rehabilitación del síndrome post-UCI en adultos: una revisión de revisiones sistemáticas

Sarita Soto Valencia , Sara Carolina Navarro Salgado , Angelly Daniela Paternina Vergara
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Abstract

Introduction

Post-ICU syndrome (PICS) is a syndrome that is becoming increasingly important due to the growing number of patients surviving critical illness, a phenomenon that has been accentuated especially after the COVID-19 pandemic. The focus of the medical practice that cares for these patients should be oriented toward the best available interventions to prevent and rehabilitate the sequelae of PICS.

Objective

To synthesize the evidence on the efficacy and effectiveness of strategies for preventing and rehabilitating PICS in adult patients.

Methods

Umbrella review (CRD42022321610). PubMed, Scopus, Ovid (Cochrane), and LILACS were searched for systematic reviews evaluating any intervention to prevent or rehabilitate PICS and its effect on any of the PICS domain(s) (i.e., mental, cognitive, or physical outcomes).

Results

20 studies were included, and 10 were classified as of low or very-low methodological quality, so they were not included in the summary of results. Therapies at the mental and cognitive levels seem to have a beneficial effect but with limited evidence. The interventions analyzed in the physical sphere are very heterogeneous and have contradictory results, with little quality of evidence.

Conclusions

Considering the systematic reviews included in this work, this research allows us to conclude that there is low-quality and contradictory information on the efficacy of interventions for the prevention or rehabilitation of PICS. Future practice should focus on developing high- quality studies.

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成人icu后综合征预防和康复策略的证据:系统综述综述
Introduction-ICU后综合征(PICS)是一种由于越来越多的患者在危重症中幸存而变得越来越重要的综合征,这一现象在新冠肺炎大流行后尤其突出。护理这些患者的医疗实践的重点应该放在预防和恢复PICS后遗症的最佳干预措施上。目的总结成人PICS预防和康复策略的有效性和有效性。方法Umbrella综述(CRD42022321610)。检索PubMed、Scopus、Ovid(Cochrane)和LILACS的系统综述,评估预防或恢复PICS的任何干预措施及其对任何PICS领域(即精神、认知或身体结果)的影响。结果纳入了20项研究,其中10项研究的方法学质量较低或极低,因此未纳入结果摘要。心理和认知层面的治疗似乎有有益的效果,但证据有限。在物理领域分析的干预措施非常异质,结果相互矛盾,证据质量很低。结论综合这项工作中的系统综述,本研究使我们得出结论,关于预防或康复PICS的干预措施的有效性,存在低质量和矛盾的信息。未来的实践应该侧重于发展高质量的研究。
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