Post-Intensive Care Syndromeと理学療法

Post-Intensive Care Syndrome (PICS)と理学療法に関するレビュー論文を紹介します。

Bemis-Dougherty AR, Smith JM. What Follows Survival of Critical Illness? Physical Therapists' Management of Patients With Post-Intensive Care Syndrome. Phys Ther. 2012 Jul 26. [Epub ahead of print]

抄録しか読めていないので詳細不明ですが、先程紹介したPICSという概念・言葉を提言した論文の理学療法版というところだと思います。この会議には、PTだけでなくOT、ST、リハ医の団体からも参加者がいますので、この点ではよいと思います。欲を言えば栄養士の参加もあればなおよかったですが。

Abstract

Historically the management of patients in the intensive care unit (ICU) involved immobilization and sedation, with the care focused on physiological impairments and survival. Because ICU patients are now surviving their hospital stay, it is imperative that their ICU care be managed with the goal of long-term health, wellness and functioning. The evidence confirms that mobilization and exercise is feasible in the ICU(1, 2) and demonstrates that the benefits of early mobilization include reduced length of stay in the ICU and hospital.(3,4) In 2010 the Society of Critical Care Medicine (SCCM) invited key stakeholder groups, including American Physical Therapy Association (APTA), to identify strategies to improve long-term consequences following ICU discharge including the importance of early mobilization within the ICU and integration of the physical therapist (PT) as a member of the ICU team. This model appears to be successful in some institutions(3,4) but there is variation among institutions.(5) The SCCM Task Force developed major areas of focus that require multidisciplinary action in order to improve long term outcomes after discharge from an intensive care unit. This paper will describe physical therapists' practice in the management of intensive care unit survivors, the importance of long term follow-up after ICU discharge, and how the APTA is taking steps to address the major areas of focus identified by the SCCM Task Force to improve long term outcomes after ICU discharge.(6).