Intensivmedizin up2date 2012; 08(02): 105-117
DOI: 10.1055/s-0032-1308926
Allgemeine Prinzipien der Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Lebensqualität nach Intensivmedizin

Hans-Georg Bone
Further Information

Publication History

Publication Date:
03 May 2012 (online)

Kernaussagen
  • Nach Intensivtherapie ist die Mortalität hoch.

  • Viele der überlebenden Patienten haben eine Einschränkung ihrer körperlichen Leistungsfähigkeit. Ursache dieser Einschränkung ist oft eine Intensivpolyneuropathie oder -myopathie.

  • Viele Patienten hatten eine körperliche Einschränkung aber schon vor der Intensivtherapie.

  • Eine Verbesserung der körperlichen Leistungsfähigkeit nach Intensivtherapie kann Jahre dauern.

  • Bei vielen Patienten kann nach längerer Intensivtherapie aber eine gute Lebensqualität erreicht werden.

  • Auch in höherem Alter ist noch eine ausreichende Lebensqualität nach Intensivtherapie möglich.

  • Die meisten der befragten Langzeitintensivpatienten würden für sich, falls erforderlich, wieder einer Intensivtherapie unterziehen.

  • Die Sicht der Ärzte und Pflegekräfte in Bezug auf eine noch lebenswerte Lebensqualität kann sich von der Sicht der betroffenen Patienten erheblich unterscheiden.

 
  • Literatur

  • 1 Hopkins RO, Herridge MS. Quality of life, emotional abnormalities, and cognitive dysfunction in survivors of acute lung injury/acute respiratory distress syndrome. Clin Chest Med 2006; 27: 679-689
  • 2 Cuthbertson BH, Roughton S, Jenkinson D et al. Quality of life in the five years after intensive care: a cohort study. Crit Care 2010; 14: R6
  • 3 Timmers TK, Verhofstad MH, Moons KG et al. Long-term quality of life after surgical intensive care admission. Arch Surg 2011; 146: 412-418
  • 4 Desai SV, Law TJ, Needham DM. Long-term complications of critical care. Crit Care Med 2011; 39: 371-379
  • 5 Gaudino M, Girola F, Piscitelli M et al. Long-term survival and quality of life of patients with prolonged postoperative intensive care unit stay: unmasking an apparent success. J Thorac Cardiovasc Surg 2007; 134: 465-469
  • 6 Engel C, Brunkhorst FM, Bone HG et al. Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med 2007; 33: 606-618
  • 7 World Health Organization. The first ten years of the World Health. Geneva: WHO; 1958
  • 8 Spilker B. Quality of life and pharmacoeconomics in clinical trials. 2nd. ed. Philadelphia: Lippincott-Raven; 1996
  • 9 Heyland DK, Guyatt G, Cook DJ et al. Frequency and methodologic rigor of quality-of-life assessments in the critical care literature. Crit Care Med 1998; 26: 591-598
  • 10 Hayes JA, Black NA, Jenkinson C et al. Outcome measures for adult critical care: a systematic review. Health Technol Assess 2000; 4: 1-111
  • 11 Ware J. SF-36 health survey: Manual and interpretation guide. Boston: The Health Institute; 1993
  • 12 The EuroQuol Group. The EuroQuol – a new facility for the measurement of health-related quality of life. Health policy 1990; 16: 199-208
  • 13 Gilson BS, Erickson D, Chavez CT et al. A Chicano version of the Sickness Impact Profile (SIP). A health care evaluation instrument crosses the linguistic barrier. Cult Med Psychiatry 1980; 4: 137-150
  • 14 Hunt SM, McKenna SP, McEwen J et al. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A 1981; 15: 221-229
  • 15 Hermans G, Wilmer A, Meersseman W et al. Impact of intensive insulin therapy on neuromuscular complications and ventilator dependency in the medical intensive care unit. Am J Respir Crit Care Med 2007; 175: 480-489
  • 16 van Mook WN, Hulsewe-Evers RP. Critical illness polyneuropathy. Curr Opin Crit Care 2002; 8: 302-310
  • 17 Van den Berghe G, Schoonheydt K, Becx P et al. Insulin therapy protects the central and peripheral nervous system of intensive care patients. Neurology 2005; 64: 1348-1353
  • 18 Griffiths RD, Jones C. Seven lessons from 20 years of follow-up of intensive care unit survivors. Curr Opin Crit Care 2007; 13: 508-513
  • 19 Herridge MS, Cheung AM, Tansey CM et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003; 348: 683-693
  • 20 Hopkins RO, Ely EW, Jackson JC. The role of future longitudinal studies in ICU survivors: understanding determinants and pathophysiology of brain dysfunction. Curr Opin Crit Care 2007; 13: 497-502
  • 21 Hopkins RO, Weaver LK, Pope D et al. Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. Am J Respir Crit Care Med 1999; 160: 50-56
  • 22 Hopkins RO, Jackson JC. Long-term neurocognitive function after critical illness. Chest 2006; 130: 869-878
  • 23 Hopkins RO, Weaver LK, Collingridge D et al. Two-year cognitive, emotional, and quality-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med 2005; 171: 340-347
  • 24 Torgersen J, Hole JF, Kvale R et al. Cognitive impairments after critical illness. Acta Anaesthesiol Scand 2011; 55: 1044-1051
  • 25 Schelling G, Roozendaal B, Krauseneck T et al. Efficacy of hydrocortisone in preventing posttraumatic stress disorder following critical illness and major surgery. Ann N Y Acad Sci 2006; 1071: 46-53
  • 26 Kapfhammer HP, Rothenhausler HB, Krauseneck T et al. Posttraumatic stress disorder and health-related quality of life in long-term survivors of acute respiratory distress syndrome. Am J Psychiatry 2004; 161: 45-52
  • 27 Griffiths RD, Jones C. Filling the intensive care memory gap?. Intensive Care Med 2001; 27: 344-346
  • 28 Kress JP, Gehlbach B, Lacy M et al. The long-term psychological effects of daily sedative interruption on critically ill patients. Am J Respir Crit Care Med 2003; 168: 1457-1461
  • 29 Granja C, Lopes A, Moreira S et al. Patients' recollections of experiences in the intensive care unit may affect their quality of life. Crit Care 2005; 9: R96-109
  • 30 Jones C, Griffiths RD, Humphris G et al. Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Crit Care Med 2001; 29: 573-580
  • 31 Schelling G, Kilger E, Roozendaal B et al. Stress doses of hydrocortisone, traumatic memories, and symptoms of posttraumatic stress disorder in patients after cardiac surgery: a randomized study. Biol Psychiatry 2004; 55: 627-633
  • 32 Lautrette A. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med 2007; 356: 469-478
  • 33 Graf J, Koch M. Health-related quality of life before, 1 month after, and 9 month after intensive care in medical cardiovascular and pulmonary patients. Crit Care Med 2003; 31: 2163-2169
  • 34 Combes A. Morbidity, mortality, and quality of life outcomes of patients requiring more than 14 days of mechanical ventilation. Crit Care Med 2003; 31: 1373-1381
  • 35 Chelluri L, Im KA. Long-term mortality and quality of life after prolonged mechanical ventilation. Crit Care Med 2004; 32: 61-69
  • 36 Dowdy DW. Quality of life in adult survivors of critical illness: a systematic review of the literature. Intensive Care Med 2005; 31: 611-620
  • 37 Hough CL, Herridge MS. Long-term outcome after acute lung injury. Curr Opin Crit Care 2012; 18: 8-15
  • 38 Herridge MS, Tansey CM, Matte A et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011; 364: 1293-1304
  • 39 Chiumello D, Taccone P, Berto V et al. Long-term outcomes in survivors of acute respiratory distress syndrome ventilated in supine or prone position. Intensive Care Med 2012; 38: 221-229
  • 40 Bienvenu OJ, Colantuoni E, Mendez-Tellez PA et al. Depressive Symptoms and Impaired Physical Function after Acute Lung Injury: a 2-Year Longitudinal Study. Am J Respir Crit Care Med 2012; 185: 517-524
  • 41 Perl TM, Dvorak L, Hwang T et al. Long-term survival and function after suspected gram-negative sepsis. Jama 1995; 274: 338-345
  • 42 Winters BD, Eberlein M, Leung J et al. Long-term mortality and quality of life in sepsis: a systematic review. Crit Care Med 2010; 38: 1276-1283
  • 43 Heyland DK, Hopman W, Coo H et al. Long-term health-related quality of life in survivors of sepsis. Short Form 36: a valid and reliable measure of health-related quality of life. Crit Care Med 2000; 28: 3599-3605
  • 44 Haraldsen P, Anderson R. Quality of life, morbidity, and mortality after surgical intensive care: a follow-up study of patients treated for abdominal sepsis in the surgical intensive care unit. Eur J Surg 2002; 168: 23-27
  • 45 Granja C, Dias C, Costa-Pereira A et al. Quality of life of survivors from severe sepsis treated in an intensive care unit. Crit Care 2004; 8: R91-98
  • 46 Montuclard L. Outcome, functional autonomy, and quality of life of elderly patients with a long-term intensive care unit stay. Crit Care Med 2000; 28: 3389-3395
  • 47 Sacanella E, Perez-Castejon JM, Nicolas JM et al. Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study. Crit Care 2011; 15: R105
  • 48 McDermid RC, Bagshaw SM. Octogenarians in the ICU: are you ever too old?. Crit Care 2011; 15: 125
  • 49 Roch A, Wiramus S, Pauly V et al. Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit. Crit Care 2011; 15: R36
  • 50 Bapat V. Survival and quality of life after cardiac surgery complicated by prolonged intensive care. J Card Surg 2005; 20: 212-217
  • 51 Sprung CL, Carmel S, Sjokvist P et al. Attitudes of European physicians, nurses, patients, and families regarding end-of-life decisions: the ETHICATT study. Intensive Care Med 2007; 33: 104-110