目的探讨ICU获得性衰弱(ICU-acquired weakness,ICU-AW)对重症患者病死率和远期生理功能的影响。方法便利抽样选择2014年12月至2016年5月之间入住江油市第二人民医院重症医学科并符合条件的276例患者为研究对象,根据有无ICU-AW分为ICU-A...目的探讨ICU获得性衰弱(ICU-acquired weakness,ICU-AW)对重症患者病死率和远期生理功能的影响。方法便利抽样选择2014年12月至2016年5月之间入住江油市第二人民医院重症医学科并符合条件的276例患者为研究对象,根据有无ICU-AW分为ICU-AW组和非ICU-AW组。记录两组患者近远期死亡例数,并对幸存者应用SF-36健康调查量表进行生理功能评估。结果与非ICU-AW组相比,ICU-AW组的年龄较大,急性生理与慢性健康(acute physiology and chronic health evaluation,APACHE II)评分较高,感染性疾病较多,机械通气时间和ICU入住时间较长,差异均有统计学意义(均P<0.05);且ICU-AW组近期病死率高于非ICU-AW组(P<0.05),而远期病死率两组间差异无统计学意义(P>0.05);出院后6个月ICU-AW组生理功能评分低于非ICU-AW组(P<0.05)。结论 ICU获得性衰弱对重症患者的近远期预后均有影响,需要积极地采取措施对ICU-AW进行预防和治疗。展开更多
ICU获得性衰弱(Intensive care unit acquired weakness,ICU-AW)是指危重症患者在ICU 内治疗时间过长,特别是长时间的机械通气,出现肌肉质量和肌力的显著下降[1],是重症患者的常见并发症之一。多项研究[2-5]显示,机械通气大于4~7d的患...ICU获得性衰弱(Intensive care unit acquired weakness,ICU-AW)是指危重症患者在ICU 内治疗时间过长,特别是长时间的机械通气,出现肌肉质量和肌力的显著下降[1],是重症患者的常见并发症之一。多项研究[2-5]显示,机械通气大于4~7d的患者出现ICU-AW可达33%~82%,一旦发生,将会对患者产生较大的影响,短期会导致机械通气时间和ICU 住院时间延长、病死率增加[6]。近年来越来越多的危重症研究者开始关注ICU-AW,认为它是相对无形但影响深远的后遗性疾病[7]。展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse outcomes.These include the need for prolonged mechanical ventilation and ICU...Intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse outcomes.These include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital costs.ICU-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical care.The pathological mechanism of ICUAW remains unclear and may be considerably varied.This review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.展开更多
文摘目的探讨ICU获得性衰弱(ICU-acquired weakness,ICU-AW)对重症患者病死率和远期生理功能的影响。方法便利抽样选择2014年12月至2016年5月之间入住江油市第二人民医院重症医学科并符合条件的276例患者为研究对象,根据有无ICU-AW分为ICU-AW组和非ICU-AW组。记录两组患者近远期死亡例数,并对幸存者应用SF-36健康调查量表进行生理功能评估。结果与非ICU-AW组相比,ICU-AW组的年龄较大,急性生理与慢性健康(acute physiology and chronic health evaluation,APACHE II)评分较高,感染性疾病较多,机械通气时间和ICU入住时间较长,差异均有统计学意义(均P<0.05);且ICU-AW组近期病死率高于非ICU-AW组(P<0.05),而远期病死率两组间差异无统计学意义(P>0.05);出院后6个月ICU-AW组生理功能评分低于非ICU-AW组(P<0.05)。结论 ICU获得性衰弱对重症患者的近远期预后均有影响,需要积极地采取措施对ICU-AW进行预防和治疗。
文摘ICU获得性衰弱(Intensive care unit acquired weakness,ICU-AW)是指危重症患者在ICU 内治疗时间过长,特别是长时间的机械通气,出现肌肉质量和肌力的显著下降[1],是重症患者的常见并发症之一。多项研究[2-5]显示,机械通气大于4~7d的患者出现ICU-AW可达33%~82%,一旦发生,将会对患者产生较大的影响,短期会导致机械通气时间和ICU 住院时间延长、病死率增加[6]。近年来越来越多的危重症研究者开始关注ICU-AW,认为它是相对无形但影响深远的后遗性疾病[7]。
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
基金supported by grants from the National Natural Science Foundation of China(grant number:82072201).
文摘Intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse outcomes.These include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital costs.ICU-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical care.The pathological mechanism of ICUAW remains unclear and may be considerably varied.This review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.
