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Die Anaesthesiologie

16.12.2024 | Post-Intensive-Care-Syndrom | Leitthema

Das Post-Intensive Care Syndrom: funktionelle Beeinträchtigungen bei Überlebenden kritischer Erkrankung

verfasst von: Dr. med. Nicolas Paul, M.Sc., Prof. Dr. med. Björn Weiss

Erschienen in: Die Anaesthesiologie

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Zusammenfassung

Mit der sinkenden Mortalität kritisch kranker Patient:innen rückten in den letzten Jahren vermehrt die gesundheitlichen Beeinträchtigungen nach Entlassung von der Intensivstation (ITS) in den Forschungsfokus. Die Mehrzahl der Überlebenden einer kritischen Erkrankung zeigt Beeinträchtigungen der Kognition, mentalen Gesundheit und körperlichen Gesundheit. Diese funktionellen Beeinträchtigungen werden seit 2012 unter dem Begriff des Post-Intensive Care Syndroms (PICS) zusammengefasst. Einschränkungen der mentalen Gesundheit betreffen v. a. neue oder aggravierte Symptome einer Depression, Angststörung und posttraumatischen Belastungsstörung. Über die Beeinträchtigungen in den drei PICS-Domänen hinaus leiden Überlebende häufig an chronischen Schmerzen, Dysphagie sowie Fehl- und Unterernährung. Zudem haben sie ein erhöhtes Risiko für Osteoporose, Knochenbrüche und die Entwicklung eines Diabetes mellitus. Zusammengenommen reduzieren diese Einschränkungen die gesundheitsbezogene Lebensqualität der ITS-Überlebenden. Zusätzliche Herausforderungen bestehen in der Wiederherstellung der sozialen Teilhabe und der Rückkehr in die Erwerbstätigkeit. Die Nachsorge ehemaliger ITS-Patient:innen wird von Betroffenen häufig als unzureichend und fragmentiert empfunden. Post-ITS-Ambulanzen könnten Verbesserungen bringen, allerdings gibt es bislang nur unzureichende Studien zu ihrer Effektivität. Auch zeigten große, hochwertige Studien zu interdisziplinären Behandlungsprogrammen von ITS-Überlebenden bislang zumeist enttäuschende Ergebnisse, sodass der Prävention und Minimierung von Risikofaktoren, beispielsweise durch konsequente Implementierung des ABCDE-Bundles, eine besondere Bedeutung zukommt. Zukünftige Forschung sollte effektive Komponenten bisheriger Interventionen identifizieren und untersuchen, welche Patientengruppen möglicherweise besonders von einer strukturierten Nachsorge in Post-ITS-Ambulanzen profitieren.
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Metadaten
Titel
Das Post-Intensive Care Syndrom: funktionelle Beeinträchtigungen bei Überlebenden kritischer Erkrankung
verfasst von
Dr. med. Nicolas Paul, M.Sc.
Prof. Dr. med. Björn Weiss
Publikationsdatum
16.12.2024
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-024-01483-5

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