Intens Care Med:急性呼吸窘迫综合征后的精神症状分析!

2018-01-08 xing.T MedSci原创

由此可见,急性呼吸窘迫综合征后第一个5年内发生焦虑症、抑郁症和创伤后应激障碍的具有临床意义的和持续性症状较为常见。对精神病史进行院内筛查,包括最近的焦虑和抑郁症状,可能有助于ARDS后的长期精神健康治疗计划。

近日,危重病医学领域权威杂志Intensive Care Medicine上发表了一篇研究文章,研究人员旨在描述急性呼吸窘迫综合征(ARDS)患者5年随访期间焦虑、抑郁和创伤后应激障碍(PTSD)症状,并确定长期精神疾病的危险因素。

这项前瞻性队列研究招募了来自4家医院的13个医疗和外科重症监护病房的患者,随访时间分别为ARDS后3、6、12、24、36、48和60个月。训练有素的研究人员在每次随访时检测了受试者医院焦虑和抑郁量表(HADS)(焦虑和抑郁症量表评分≥8分表示大症状众多)和修订版事件量表(IES-R,评分≥1.6,表明严重的PTSD症状)。

在196名知情的幸存者中,186名(95%)完成了HADS和IES-R评估; 96例(52%)幸存者有持续或反复(长期)症状,71例(38%),59例(32%)和43例(23%)分别有长期焦虑、抑郁和PTSD症状(总的中位持续时间为33-39个月)。长期的精神症状倾向于跨领域共同发生;最常见的发病模式涉及三个领域的实质症状。ARDS前更严重的心理健康,包括ARDS之前的抑郁症和心理困扰,与ARDS后长期精神病发病密切相关。

由此可见,急性呼吸窘迫综合征后第一个5年内发生焦虑症、抑郁症和创伤后应激障碍的具有临床意义的和持续性症状较为常见。对精神病史进行院内筛查,包括最近的焦虑和抑郁症状,可能有助于ARDS后的长期精神健康治疗计划。

原始出处:

O. Joseph Bienvenu,et al. Psychiatric symptoms after acute respiratory distress syndrome: a 5-year longitudinal study.Intensive Care Med.2018.http://icmjournal.esicm.org/journals/abstract.html?v=0&j=134&i=0&a=5009_10.1007_s00134-017-5009-4&doi=

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    2018-01-08 smartxiuxiu

    值得探讨

    0

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    2018-01-08 明月清辉

    谢谢分享.学习了

    0

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体外膜肺氧合(ECMO)是挽救急性呼吸窘迫综合征(ARDS)患者生命的一种疗法,但其与并发症和花费成本相关。近期,一项发表在杂志Crit care上的研究验证了分数差异对预测死亡率和发展优化的分类模型。此项研究为推导队列研究,对108例静脉-静脉ECMO的ARDS患者(2010-2015)进行了回顾性分析,以评估对死亡率预测(受试者操作)的四个已建立的风险评分(ECMOnet评分,RESP评分,P

Anesth Analg:较之异氟醚,七氟醚可很大程度减轻大鼠肺源性急性呼吸窘迫综合征引起的肺损伤

挥发性麻醉药能调节急性呼吸窘迫综合征(ARDS)中的炎症反应。而它们是否因为ARDS病因的不同而呈现出不同作用,目前尚不十分清楚。我们假设体内、体外实验中,七氟醚和异氟醚在肺源性(p)和非肺源性(exp)ARDS对肺损伤的影响中不存在差异。

Clin Respir J:研究发现Lnc-IL7R是诊断ARDS的新的生物标志物

已知长链非编码RNA(lncRNA)参与调节各种基因和生物过程。Lnc-IL7R参与炎症的调节,但其在急性呼吸窘迫综合征(ARDS)中的作用则尚未明了。本研究中,研究人员检测了IL-IL7R作为ARDS潜在生物标志物的作用。研究人员从ARDS患者血浆和健康对照者中分离LncRNA-IL7R,并在患者入院后24 h内获得其临床指标。通过定量实时PCR获得IL-IL7R的相对表达。使用Spearman

Am J Resp Crit Care:危重病患者肺脏菌群与吸烟状况及ARDS的发生有关!

在严重钝性创伤患者中,吸烟与ICU入院时和48小时后的肺脏菌群构成有关。ARDS的发生与入住ICU48小时内的呼吸微生物群落结构有关,并且在ICU入住时的吸烟者中相对富集。这项试验研究的数据表明,肺组织中与吸烟有关的菌群变化可能与严重创伤后ARDS的发展有关。

Crit Care:透明质酸与急性呼吸窘迫综合征的器官功能障碍!

由此可见,肺泡中HA水平升高与LIS相关,而循环中HA水平与肺损伤和SOFA评分相关。这些发现提示HA在ARDS患者的局部和全身器官功能障碍中发挥潜在的作用。