COVID-19患者在重症监护病房(ICU)的住院时间超过了平均3至4天。, says Megan Hosey约翰霍普金斯医院重症监护室的康复心理学家. 这使得他们患重症监护后综合症(PICS)的风险更大。.
While more patients than ever are surviving after treatment in the ICU, 过去二十年的研究表明，生存可能伴随着一系列的身体疾病, 与PICS相关的心理和认知症状-在未来数周或数年内阻碍患者的生活质量. Although the exact prevalence of PICS is unknown, “it happens in more patients than we probably realize,” says Hosey, and it is occurring in some patients with COVID-19.
新冠肺炎患者急性呼吸窘迫综合征和焦虑的治疗
Hosey works closely Dale Needham, 约翰霍普金斯大学重症监护医师和研究员，因推进PICS研究而享誉国际. 尼德姆说，COVID-19患者会患上肺炎，导致急性呼吸窘迫综合征(ARDS)。. These patients require a ventilator in the ICU, and, for patients with COVID-19 and ARDS, it’s not unusual to be on a ventilator for more than two weeks. 重症监护病房的其他COVID-19患者通常需要吸氧或高浓度吸氧.
Hosey also works with Joe Bienvenu他是约翰霍普金斯大学的精神病学家，研究危重疾病和重症监护的幸存者. As of mid-April, 2020, Bienvenu和Hosey发现，在ICU的COVID-19患者中，最令人担忧的情况之一是 anxiety. Reasons include having difficulty breathing, being away from family, fear of getting others sick and fear of reports in the media.
Lately, 霍西一直在通过电话和视频会议与这些患者进行远程互动，以减少冠状病毒的传播，并保存个人防护装备. 患者使用房间里的电话和平板电脑进行这些访问.
护理的一个重要方面是找到对这些推荐十大正规网赌平台来说生命最有价值的东西. “Even in the ICU, 我们试图帮助推荐十大正规网赌平台看到他们生活中快乐和有意义的事情，因为这些(提醒)可以防止焦虑和 depression. 你越早回到这些活动中——甚至谈论它们——就越好,” says Hosey.
Hosey还通过联系家庭成员来帮助患者更好地了解患者的病史以及帮助他们应对的方法. In addition, 这些电话让家人确信她在照顾他们的亲人, even though they are unable to visit.
Recognizing Delirium in Patients with COVID-19
Along with anxiety, Hosey和Bienvenu对重症监护室COVID-19患者心理健康的最大担忧是谵妄.
当推荐十大正规网赌平台处于不熟悉的环境时，就会出现这种情况, 在镇定剂下，加班加点地工作以对抗感染或从受伤中恢复, says Bienvenu. Patients often describe frightening nightmare-like experiences, sometimes with themes of betrayal by doctors and nurses — at times, even by loved ones.
Hosey说，重症监护室中COVID-19患者谵妄的患病率特别高, 可能是由于让患者长时间使用呼吸机所需的镇静剂量.
Unfortunately, the effects of delirium can linger. “Even after it resolves,” Bienvenu says, “这些记忆会对心理健康产生下游影响——增加焦虑症状, depression or post-traumatic stress disorder. Patients may have anxious reactions when they see a hospital. They find themselves wanting to avoid hospitals, and becoming very fearful that they will get sick again.”
Because delirium can also cause cognitive changes in attention, thinking and memory that last beyond hospitalization, Hosey向推荐十大正规网赌平台介绍了如何与了解重症监护后综合症的心理健康提供者取得联系.
身体，语言和职业治疗师报告到约翰霍普金斯大学ICU
According to Jennifer Zanni, 约翰霍普金斯大学的物理治疗师，在重症监护室工作了18年，现在专门研究 intensive outpatient post-acute rehabilitation, 约翰·霍普金斯康复中心的许多治疗师被重新分配到约翰·霍普金斯医院. These physical, 语言和职业治疗师的重点是COVID-19住院患者的早期康复, including helping with patient proning in the ICU. 尼德姆说，坊间证据表明，药物治疗对严重的糖尿病患者有效 pneumonia and COVID-19.
Early Rehabilitation in the ICU Helps Recovery from COVID-19
By helping patients manage their health in the ICU as early as possible, Hosey认为，患者将会更好地参与下一阶段的康复. “国内很少有重症监护室为患者提供我们在霍普金斯提供的早期康复的数量和强度,” she says.
Needham agrees. “我们有一个特别的项目，定期提供心理和身体帮助, occupational and speech therapy, on top of medical care in the ICU. During the pandemic, this program continues.”
Soon, 从COVID-19恢复的患者将有一个方便的资源来报告和监测他们的健康状况, including PICS. Ann Marie Parker, 他是约翰·霍普金斯大学的医生，专门从事肺部和重症监护医学, as well as delirium and rehabilitation in the ICU, is creating a virtual clinic for COVID-19 survivors.
有关约翰霍普金斯大学物理医学和康复部门如何实现康复的更多信息, attend an Upcoming Webinar.
