重症监护后综合征筛查:法国多中心调查。

IF 5.7 1区 医学 Q1 CRITICAL CARE MEDICINE Annals of Intensive Care Pub Date : 2024-07-09 DOI:10.1186/s13613-024-01341-y
Maïté Agbakou, Margot Combet, Maëlle Martin, Gauthier Blonz, Luc Desmedt, Amélie Seguin, Jérémie Lemarié, Olivier Zambon, Jean Reignier, Jean-Baptiste Lascarrou, Stephan Ehrmann, Emmanuel Canet
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引用次数: 0

摘要

背景:重症监护室出院后综合征(PICS)是指重症监护室(ICU)出院后长期存在的身体、认知和精神健康症状。有关 PICS 筛查的数据很少。我们在此旨在介绍法国的重症监护室出院后筛查情况,特别关注就诊机会和就诊期间所做的评估:我们通过电子邮件向法国的重症监护病房发送了一份包含 43 个项目的匿名问卷,从而开展了一项在线多中心调查。每间重症监护室都向负责随访的负责人或重症监护医师发送了一份调查问卷:在受邀参与调查的 252 个 ICU 中,有 161 个(63.9%)ICU 返回了填写完整的调查问卷。其中,46 家(28.6%)提供了随访服务。通常情况下,由一名重症监护医师带领的一次随访安排在重症监护病房出院后的 3 至 6 个月。每年每间重症监护室约有 50 名患者(约占入院患者的 5%)接受重症监护室出院后的随访。选择患者进行随访的主要标准是:ICU住院时间和/或有创机械通气时间超过 48 小时、心脏骤停、脓毒性休克和急性呼吸窘迫综合征。在提供随访服务的 ICU 中,80% 的 ICU 使用经过验证的工具筛查 PICS。在 115 个未提供随访的 ICU 中,有 50 个(43.5%)表示有意在未来一年内开始随访。提供随访的主要障碍是缺乏可用的人员和设备,或未将 PICS 筛查视为优先事项。提供随访的 ICU 中,有一半与已建立的 ICU 后护理专业人员网络合作,另有 17% 正在建立这样的网络。建立网络的障碍是医护人员缺乏兴趣以及缺乏有关 PICS 的专门培训:结论:只有少数 ICU 幸存者接受了旨在检测 PICS 的随访。只有不到三分之一的重症监护病房提供随访服务,但另有近三分之一的重症监护病房计划在明年内开展此类随访服务。法国卫生当局将于2023年发布相关建议,有望改善ICU术后随访的可用性和标准化。
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Post-intensive care syndrome screening: a French multicentre survey.

Background: Post-intensive care syndrome (PICS), defined as physical, cognitive, and mental-health symptoms persisting long after intensive-care-unit (ICU) discharge, is increasingly recognised as a healthcare priority. Data on screening for PICS are sparse. Our objective here was to describe post-ICU screening in France, with special attention to visit availability and evaluations done during visits.

Methods: We conducted an online multicentre survey by emailing an anonymous 43-item questionnaire to French ICUs. For each ICU, a single survey was sent to either the head or the intensivist in charge of follow-up visits.

Results: Of 252 ICUs invited to participate, 161 (63.9%) returned the completed survey. Among them, 46 (28.6%) offered follow-up visits. Usually, a single visit led by an intensivist was scheduled 3 to 6 months after ICU discharge. Approximately 50 patients/year/ICU, that is, about 5% of admitted patients, attended post-ICU visits. The main criteria used to select patients for follow-up were ICU stay and/or invasive mechanical ventilation duration longer than 48 h, cardiac arrest, septic shock, and acute respiratory distress syndrome. Among ICUs offering visits, 80% used validated instruments to screen for PICS. Of the 115 ICUs not offering follow-up, 50 (43.5%) indicated an intention to start follow-up within the next year. The main barriers to offering follow-up were lack of available staff and equipment or not viewing PICS screening as a priority. Half the ICUs offering visits worked with an established network of post-ICU care professionals, and another 17% were setting up such a network. Obstacles to network creation were lack of interest among healthcare professionals and lack of specific training in PICS.

Conclusion: Only a small minority of ICU survivors received follow-up designed to detect PICS. Less than a third of ICUs offered follow-up visits but nearly another third planned to set up such visits within the next year. Recommendations issued by French health authorities in 2023 can be expected to improve the availability and standardisation of post-ICU follow-up.

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来源期刊
Annals of Intensive Care
Annals of Intensive Care CRITICAL CARE MEDICINE-
CiteScore
14.20
自引率
3.70%
发文量
107
审稿时长
13 weeks
期刊介绍: Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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