Download PDF
intensiv 2004; 12(5): 206-217
DOI: 10.1055/s-2004-812914
Intensivpflege

© Georg Thieme Verlag KG Stuttgart · New York

Überleben nach der Intensivtherapie

Markus Wehler1 , Richard Strauß1 , Eckhardt G. Hahn1
  • 1Medizinische Klinik I mit Poliklinik der Universität Erlangen-Nürnberg, Erlangen, (Direktor: Prof. Dr. med. E.G. Hahn, FACP)
Further Information

Publication History

Publication Date:
16 September 2004 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Im Rahmen dieser Übersicht werden einige wesentliche Aspekte des Langzeitüberlebens und der Morbidität von ehemaligen Intensivpatienten dargestellt. Das Langzeitüberleben von Patienten nach Intensivtherapie ist im Wesentlichen vom Abbau der physiologischen Reserven durch die Akuterkrankung und von fortschreitenden Grunderkrankungen abhängig. Hohes Alter beeinflusst vor allem die kurzfristige Mortalität innerhalb der ersten 30 Tage, während ein septisches Mehrorganversagen die Sterblichkeit über Jahre beeinflussen kann. Im Weiteren wird dargestellt, warum ehemalige Intensivpatienten oft viele Monate über eine reduzierte körperliche Leistungsfähigkeit klagen und welche neuropsychologischen Konsequenzen eine kritische Erkrankung und deren Behandlung haben kann. Ein weiteres Kapitel beschäftigt sich mit den sozioökonomischen Be­lastungen von Patienten und ihren Angehörigen. Die strukturiert erfasste gesundheitsbezogene Lebensqualität als klinischer Endpunkt der Ergebnisqualität intensivmedizinischer Leistungen gewinnt zunehmend an Bedeutung, indirekte Ansätze, die Lebensqualität zu erfassen, gehen mehr auf den Lebenswunsch ehemaliger Intensivpatienten in ihrem jeweiligen Gesundheitszustand ein. Während bisherige Nachsorgestudien die Probleme ehemaliger Intensivpatienten meist rein deskriptiv erfasst haben, sollte ein zukünftiger Forschungsschwerpunkt in der Aufdeckung kausaler Beziehungen zwischen intensivmedizinischer Behandlung und nachintensivstationärer Morbidität liegen. Hierdurch könnte die Qualität des Überlebens nachhaltig verbessert werden.

Literatur

  • 1 Niskanen M, Kari A, Halonen P. Five-year survival after intensive care-comparison of 12,180 patients with the general population. Finnish ICU Study Group.  Crit Care Med. 1996;  24 1962-1967
    Google Scholar
  • 2 Frutiger A, Ryf C, Bilat C. et al . Five years’ follow-up of severely injured ICU patients.  J Trauma. 1991;  31 1216-1225
    Google Scholar
  • 3 Mahul P, Perrot D, Tempelhoff G. et al . Short- and long-term prognosis, functional outcome following ICU for elderly.  Intensive Care Med. 1991;  17 7-10
    CrossrefPubMedGoogle Scholar
  • 4 Quartin A A, Schein R M, Kett D H. et al . Magnitude and duration of the effect of sepsis on survival. Department of Veterans Affairs Systemic Sepsis Cooperative Studies Group.  JAMA. 1997;  277 1058-1063
    CrossrefGoogle Scholar
  • 5 Keenan S P, Dodek P, Chan K. et al . Intensive care unit admission has minimal impact on long-term mortality.  Crit Care Med. 2002;  30 501-507
    Google Scholar
  • 6 Herridge M S. Long-term outcomes after critical illness.  Curr Opin Crit Care. 2002;  8 331-336
    Google Scholar
  • 7 Broomhead L R, Brett S J. Clinical review: Intensive care follow-up - what has it told us?.  Crit Care. 2002;  6 411-417
    CrossrefGoogle Scholar
  • 8 Herridge M S. Morbidity and functional limitation in survivors of ARDS. Angus DC, Carlet J Surviving intensive care Berlin; Springer 2003: 21-33
    Google Scholar
  • 9 Plank L D, Connolly A B, Hill G L. Sequential changes in the metabolic response in severely septic patients during the first 23 days after the onset of peritonitis.  Ann Surg. 1998;  228 146-158
    CrossrefGoogle Scholar
  • 10 Plank L D, Hill G L. Energy balance in critical illness.  Proc Nutr Soc. 2003;  62 545-552
    CrossrefPubMedGoogle Scholar
  • 11 Kvale R, Ulvik A, Flaatten H. Follow-up after intensive care: a single center study.  Intensive Care Med. 2003;  29 2149-2156
    CrossrefGoogle Scholar
  • 12 Herridge M S, Cheung A M, Tansey C M. et al . One-year outcomes in survivors of the acute respiratory distress syndrome.  N Engl J Med. 2003;  348 683-693
    CrossrefPubMedGoogle Scholar
  • 13 Taylor H L, Henschel A, Mickelsen O. et al . Some effects of acute starvation with hard work on body weight, body fluids and metabolism.  J Appl Physiol. 1954;  6 613-623
    Google Scholar
  • 14 Griffiths R D. Nutrition after intensive care. Griffiths RD, Jones C Intensive care aftercare Oxford; Butterworth-Heinemann 2002: 48-52
    Google Scholar
  • 15 Hund E. Critical illness polyneuropathy.  Curr Opin Neurol. 2001;  14 649-653
    CrossrefGoogle Scholar
  • 16 Hund E. Neurological complications of sepsis: critical illness polyneuropathy and myopathy.  J Neurol. 2001;  248 929-934
    CrossrefGoogle Scholar
  • 17 De Jonghe B, Sharshar T, Lefaucheur J P. et al . Paresis acquired in the intensive care unit: a prospective multicenter study.  JAMA. 2002;  288 2859-2867
    CrossrefPubMedGoogle Scholar
  • 18 Berek K, Margreiter J, Willeit J. et al . Polyneuropathies in critically ill patients: a prospective evaluation.  Intensive Care Med. 1996;  22 849-855
    CrossrefGoogle Scholar
  • 19 Witt N J, Zochodne D W, Bolton C F. et al . Peripheral nerve function in sepsis and multiple organ failure.  Chest. 1991;  99 176-184
    Google Scholar
  • 20 Hund E, Genzwurker H, Bohrer H. et al . Predominant involvement of motor fibres in patients with critical illness polyneuropathy.  Br J Anaesth. 1997;  78 274-278
    Google Scholar
  • 21 De Seze M, Petit H, Wiart L. et al . Critical illness polyneuropathy. A 2-year follow-up study in 19 severe cases.  Eur Neurol. 2000;  43 61-69
    CrossrefGoogle Scholar
  • 22 Fletcher S N, Kennedy D D, Ghosh I R. et al . Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness.  Crit Care Med. 2003;  31 1012-1016
    CrossrefGoogle Scholar
  • 23 Peters J I, Bell R C, Prihoda T J. et al . Clinical determinants of abnormalities in pulmonary functions in survivors of the adult respiratory distress syndrome.  Am Rev Respir Dis. 1989;  139 1163-1168
    Google Scholar
  • 24 McHugh L G, Milberg J A, Whitcomb M E. et al . Recovery of function in survivors of the acute respiratory distress syndrome.  Am J Respir Crit Care Med. 1994;  150 90-94
    CrossrefGoogle Scholar
  • 25 Schelling G, Stoll C, Vogelmeier C. et al . Pulmonary function and health-related quality of life in a sample of long-term survivors of the acute respiratory di­stress syndrome.  Intensive Care Med. 2000;  26 1304-1311
    CrossrefGoogle Scholar
  • 26 Desai S R, Wells A U, Rubens M B. et al . Acute respiratory distress syndrome: CT abnormalities at long-term follow-up.  Radiology. 1999;  210 29-35
    CrossrefGoogle Scholar
  • 27 Nobauer-Huhmann I M, Eibenberger K, Schaefer-Prokop C. et al . Changes in lung parenchyma after acute respiratory di­stress syndrome (ARDS): assessment with high-resolution computed tomography.  Eur Radiol. 2001;  11 2436-2443
    CrossrefGoogle Scholar
  • 28 Weinert C R, Gross C R, Kangas J R. et al . Health-related quality of life after acute lung injury.  Am J Respir Crit Care Med. 1997;  156 1120-1128
    CrossrefGoogle Scholar
  • 29 Davidson T A, Caldwell E S, Curtis J R. et al . Reduced quality of life in survivors of acute respiratory distress syndrome compared with critically ill control patients.  JAMA. 1999;  281 354-360
    CrossrefGoogle Scholar
  • 30 Jones J, Hoggart B, Withey J. et al . What the patients say: A study of reactions to an intensive care unit.  Intensive Care Med. 1979;  5 89-92
    Google Scholar
  • 31 Turner J S, Briggs S J, Springhorn H E. et al . Patients’ recollection of intensive care unit experience.  Crit Care Med. 1990;  18 966-968
    Google Scholar
  • 32 Biley F C. Effects of noise in hospitals.  Br J Nurs. 1994;  3 110-113
    Google Scholar
  • 33 Rotondi A J, Chelluri L, Sirio C. et al . Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit.  Crit Care Med. 2002;  30 746-752
    CrossrefPubMedGoogle Scholar
  • 34 Russell S. An exploratory study of patients’ perceptions, memories and experiences of an intensive care unit.  J Adv Nurs. 1999;  29 783-791
    CrossrefGoogle Scholar
  • 35 Rundshagen I, Schnabel K, Wegner C. et al . Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care.  Intensive Care Med. 2002;  28 38-43
    CrossrefGoogle Scholar
  • 36 Nelson J E, Meier D E, Oei E J. et al . Self-reported symptom experience of critically ill cancer patients receiving intensive care.  Crit Care Med. 2001;  29 277-282
    CrossrefGoogle Scholar
  • 37 Parthasarathy S, Tobin M J. Sleep in the intensive care unit.  Intensive Care Med. 2003;  Oct 16 2003 DOI: 10.1007/s00134-00003-02030-00136
    Google Scholar
  • 38 Ely E W, Margolin R, Francis J. et al . Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).  Crit Care Med. 2001;  29 1370-1379
    CrossrefPubMedGoogle Scholar
  • 39 Geary S M. Intensive care unit psychosis revisited: understanding and managing delirium in the critical care setting.  Crit Care Nurs Q. 1994;  17 51-63
    Google Scholar
  • 40 Granberg A, Engberg I B, Lundberg D. Intensive care syndrome: a literature review.  Intensive Crit Care Nurs. 1996;  12 173-182
    Google Scholar
  • 41 Inouye S K, Bogardus S T Jr, Charpentier P A. et al . A multicomponent intervention to prevent delirium in hospitalized older patients.  N Engl J Med. 1999;  340 669-676
    CrossrefPubMedGoogle Scholar
  • 42 Ely E W, Gautam S, Margolin R. et al . The impact of delirium in the intensive care unit on hospital length of stay.  Intensive Care Med. 2001;  27 1892-1900
    CrossrefPubMedGoogle Scholar
  • 43 Sukantarat K T, Brett S J. The neuropsychological consequences of intensive care. Angus DC, Carlet J Surviving intensive care Berlin; Springer 2003: 51-61
    Google Scholar
  • 44 Claussen P C. Herzwechsel.  Herz. 2001;  26 305-315
    Google Scholar
  • 45 Hopkins R O, Weaver L K, 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
    CrossrefGoogle Scholar
  • 46 Hopkins R O, Kesner R P, Goldstein M. Item and order recognition memory in subjects with hypoxic brain injury.  Brain Cogn. 1995;  27 180-201
    Google Scholar
  • 47 Rothenhausler H B, Ehrentraut S, Stoll C. et al . The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: results of an exploratory study.  Gen Hosp Psychiatry. 2001;  23 90-96
    CrossrefGoogle Scholar
  • 48 Newman M F, Kirchner J L, Phillips-Bute B. et al . Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery.  N Engl J Med. 2001;  344 395-402
    CrossrefGoogle Scholar
  • 49 Jackson J C, Hart R P, Gordon S M. et al . Six-month neuropsychological outcome of medical intensive care unit patients.  Crit Care Med. 2003;  31 1226-1234
    CrossrefPubMedGoogle Scholar
  • 50 Scragg P, Jones A, Fauvel N. Psychological problems following ICU treatment.  Anaesthesia. 2001;  56 9-14
    CrossrefGoogle Scholar
  • 51 Nelson B J, Weinert C R, Bury C L. et al . Intensive care unit drug use and subsequent quality of life in acute lung injury patients.  Crit Care Med. 2000;  28 3626-3630
    CrossrefGoogle Scholar
  • 52 Eddleston J M, White P, Guthrie E. Survival, morbidity, and quality of life after discharge from intensive care.  Crit Care Med. 2000;  28 2293-2299
    Google Scholar
  • 53 Wehler M, Martus P, Geise A. et al . Changes in quality of life after medical intensive care.  Intensive Care Med. 2001;  27 154-159
    CrossrefGoogle Scholar
  • 54 Wehler M, Geise A, Hadzionerovic D. et al . Health-related quality of life of patients with multiple organ dysfunction: Individual changes and comparison with normative population.  Crit Care Med. 2003;  31 1094-1101
    CrossrefGoogle Scholar
  • 55 Compton P. Critical illness and intensive care: what it means to the client.  Crit Care Nurse. 1991;  11 50-56
    Google Scholar
  • 56 Hupcey J E, Zimmerman H E. The need to know: experiences of critically ill patients.  Am J Crit Care. 2000;  9 192-198
    Google Scholar
  • 57 Griffiths R D, Jones C. Filling the intensive care memory gap?.  Intensive Care Med. 2001;  27 344-346
    CrossrefGoogle Scholar
  • 58 Backman C G, Walther S M. Use of a personal diary written on the ICU during critical illness.  Intensive Care Med. 2001;  27 426-429
    CrossrefGoogle Scholar
  • 59 Kvale R, Flaatten H. Changes in health-related quality of life from 6 months to 2 years after discharge from intensive care.  Health Qual Life Outcomes. 2003;  1 2-11
    CrossrefGoogle Scholar
  • 60 Hewitt P B. Subjective follow-up of patients from a surgical intensive therapy ward.  Br Med J. 1970;  4 669-673
    Google Scholar
  • 61 Jones C, Griffiths R D, 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
    CrossrefGoogle Scholar
  • 62 Aurell J, Elmqvist D. Sleep in the surgical intensive care unit: continuous polygraphic recording of sleep in nine patients receiving postoperative care.  Br Med J. 1985;  290 1029-1032
    CrossrefGoogle Scholar
  • 63 Stickgold R, Hobson J A, Fosse R. et al . Sleep, learning, and dreams: off-line memory reprocessing.  Science. 2001;  294 1052-1057
    CrossrefGoogle Scholar
  • 64 Jones C, Griffiths R D. Physical and psychological recovery. Griffiths RD, Jones C Intensive care aftercare Oxford; Butterworth-Heinemann 2002: 53-65
    Google Scholar
  • 65 Ballenger J C, Davidson J R, Lecrubier Y. et al . Consensus statement on posttraumatic stress disorder from the International Consensus Group on Depression and Anxiety.  J Clin Psychiatry. 2000;  61 60-66
    Google Scholar
  • 66 Yehuda R. Post-traumatic stress disorder.  N Engl J Med. 2002;  346 108-114
    CrossrefPubMedGoogle Scholar
  • 67 Schelling G, Stoll C, Haller M. et al . Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome.  Crit Care Med. 1998;  26 651-659
    CrossrefPubMedGoogle Scholar
  • 68 Cuthbertson B H, Hull A, Strachan M. et al . Post-traumatic stress disorder after critical illness requiring general intensive care.  Intensive Care Med. 2003;  Sep 5 DOI: 10.1007/s00134-00003-02004-00138
    Google Scholar
  • 69 Koshy G, Wilkinson A, Harmsworth A. et al . Intensive care unit follow-up program at a district general hospital.  Intensive Care Med. 1997;  23 S160, A301
    Google Scholar
  • 70 Schelling G, Stoll C, Kapfhammer H P. et al . The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health-related quality of life in survivors.  Crit Care Med. 1999;  27 2678-2683
    CrossrefGoogle Scholar
  • 71 Foa E B. Psychosocial treatment of posttraumatic stress disorder.  J Clin Psychiatry. 2000;  61 43-48
    Google Scholar
  • 72 Elliott D. Measuring the health outcomes of general ICU patients: a systematic review of methods and findings.  Aust Crit Care. 1999;  12 132-140
    Google Scholar
  • 73 Hayes J A, Black N A, Jenkinson C. et al . Outcome measures for adult critical care: a systematic review.  Health Technol Assess. 2000;  4 1-111
    Google Scholar
  • 74 Oreskovich M R, Howard J D, Copass M K. et al . Geriatric trauma: injury patterns and outcome.  J Trauma. 1984;  24 565-572
    Google Scholar
  • 75 Goins W A, Reynolds H N, Nyanjom D. et al . Outcome following prolonged intensive care unit stay in multiple trauma patients.  Crit Care Med. 1991;  19 339-345
    Google Scholar
  • 76 Douglas S L, Daly B J, Brennan P F. et al . Outcomes of long-term ventilator patients: a descriptive study.  Am J Crit Care. 1997;  6 99-105
    Google Scholar
  • 77 Parno J R, Teres D, Lemeshow S. et al . Two-year outcome of adult intensive care patients.  Med Care. 1984;  22 167-176
    Google Scholar
  • 78 Stambrook M, Moore A D, Peters L C. et al . Effects of mild, moderate and severe closed head injury on long-term vocational status.  Brain Inj. 1990;  4 183-190
    Google Scholar
  • 79 Brenneman F D, Redelmeier D A, Boulanger B R. et al . Long-term outcomes in blunt trauma: who goes back to work?.  J Trauma. 1997;  42 778-781
    Google Scholar
  • 80 Nordback I H, Auvinen O A. Long-term results after pancreas resection for acute necrotizing pancreatitis.  Br J Surg. 1985;  72 687-689
    CrossrefGoogle Scholar
  • 81 Pochard F, Azoulay E, Chevret S. et al . Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity.  Crit Care Med. 2001;  29 1893-1897
    CrossrefPubMedGoogle Scholar
  • 82 Jones C, Griffiths R D, Macmillan R. et al . Psychological problems occurring after intensive care.  Br J Intensive Care. 1994;  26 46-53
    Google Scholar
  • 83 Covinsky K E, Goldman L, Cook E F. et al . The impact of serious illness on patients’ families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.  Jama. 1994;  272 1839-1844
    CrossrefGoogle Scholar
  • 84 Quality of Life after Mechanical Ventilation in the Aged Study Investigators: 2-month mortality and functional status of critically ill adult patients receiving prolonged mechanical ventilation.  Chest. 2002;  121 549-558
    CrossrefPubMedGoogle Scholar
  • 85 Le G all JR, Brun-Buisson C, Trunet P. et al . Influence of age, previous health status, and severity of illness on outcome from intensive care.  Crit Care Med. 1982;  10 575-577
    Google Scholar
  • 86 Jacobs C J, van der Vliet J A, van Roozendaal M T. et al . Mortality and quality of life after intensive care for critical illness.  Intensive Care Med. 1988;  14 217-220
    CrossrefGoogle Scholar
  • 87 Konopad E, Noseworthy T W, Johnston R. et al . Quality of life measures before and one year after admission to an intensive care unit.  Crit Care Med. 1995;  23 1653-1659
    Google Scholar
  • 88 Capuzzo M, Bianconi M, Contu P. et al . Survival and quality of life after intensive care.  Intensive Care Med. 1996;  22 947-953
    CrossrefGoogle Scholar
  • 89 Ridley S A, Chrispin P S, Scotton H. et al . Changes in quality of life after intensive care: comparison with normal data.  Anaesthesia. 1997;  52 195-202
    CrossrefGoogle Scholar
  • 90 Graf J, Koch M, Dujardin R. et al . Health-related quality of life before, 1 month after, and 9 months after intensive care in medical cardiovascular and pulmonary patients.  Crit Care Med. 2003;  31 2163-2169
    CrossrefGoogle Scholar
  • 91 Vazquez M ata G, Rivera F ernandez R, Gonzalez C armona A. et al . Factors related to quality of life 12 months after discharge from an intensive care unit.  Crit Care Med. 1992;  20 1257-1262
    Google Scholar
  • 92 Patrick D L, Danis M, Southerland L I. et al . Quality of life following intensive care.  J Gen Intern Med. 1988;  3 218-223
    Google Scholar
  • 93 Yinnon A, Zimran A, Hershko C. Quality of life and survival following intensive medical care.  Q J Med. 1989;  71 347-357
    Google Scholar
  • 94 Brooks R, Bauman A, Daffurn K. et al . Post-hospital outcome following intensive care.  Clin Intensive Care. 1995;  6 127-135
    Google Scholar
  • 95 Fakhry S M, Kercher K W, Rutledge R. Survival, quality of life, and charges in critically III surgical patients requiring prolonged ICU stays.  J Trauma. 1996;  41 999-1007
    Google Scholar
  • 96 Sprangers M A, Schwartz C E. Integrating response shift into health-related quality of life research: a theoretical model.  Soc Sci Med. 1999;  48 1507-1515
    CrossrefGoogle Scholar
  • 97 Nielsen D, Sellgren J, Ricksten S E. Quality of life after cardiac surgery complicated by multiple organ failure.  Crit Care Med. 1997;  25 52-57
    Google Scholar
  • 98 Welsh C H, Thompson K, Long-Krug S. Evaluation of patient-perceived health status using the Medical Outcomes Survey Short-Form 36 in an intensive care unit population.  Crit Care Med. 1999;  27 1466-1471
    Google Scholar
  • 99 Clermont G, Angus D C, Linde-Zwirble W T. et al . Does acute organ dysfunction predict patient-centered outcomes?.  Chest. 2002;  121 1963-1971
    CrossrefGoogle Scholar
  • 100 Sprangers M A, Moinpour C M, Moynihan T J. et al . Assessing meaningful change in quality of life over time: a users’ guide for clinicians.  Mayo Clin Proc. 2002;  77 561-571
    CrossrefPubMedGoogle Scholar
  • 101 Heyland D K, Guyatt G, Cook D J. et al . Frequency and methodologic rigor of quality-of-life assessments in the critical care literature.  Crit Care Med. 1998;  26 591-598
    CrossrefGoogle Scholar
  • 102 Kutsogiannis D J, Noseworthy T. Quality of life after critical care. Ridley S Outcomes in critical care Oxford; Butterworth-Heinemann 2002: 139-168
    Google Scholar
  • 103 Graf J, Janssens U. Der Post-Intensiv­patient. Langzeitüberleben und Le­bensqualität nach Intensivtherapie.  Intensivmedizin und Notfallmedizin. 2003;  40 184-194
    CrossrefGoogle Scholar
  • 104 Rowan K, Jenkinson C, Black N. Health-related quality of life. Angus DC, Carlet J Surviving intensive care Berlin; Springer 2003: 35-50
    Google Scholar
  • 105 Everhart M A, Pearlman R A. Stability of patient preferences regarding life-sustaining treatments.  Chest. 1990;  97 159-164
    Google Scholar
  • 106 Elpern E H, Patterson P A, Gloskey D. et al . Patients’ preferences for intensive care.  Crit Care Med. 1992;  20 43-47
    Google Scholar
  • 107 Chelluri L, Pinsky M R, Donahoe M P. et al . Long-term outcome of critically ill elderly patients requiring intensive care.  JAMA. 1993;  269 3119-3123
    CrossrefGoogle Scholar
  • 108 Danis M, Patrick D L, Southerland L I. et al . Patients’ and families’ preferences for medical intensive care.  JAMA. 1988;  260 797-802
    CrossrefGoogle Scholar
  • 109 Mendelsohn A B, Steven H B, Fischhoff B. et al . How patients feel about prolonged mechanical ventilation 1 yr later.  Crit Care Med. 2002;  30 1439-1445
    Google Scholar
  • 110 Mendelsohn A B, Chelluri L. Interviews with intensive care unit survivors: Assessing post-intensive care quality of life and patients’ preferences regarding intensive care and mechanical ventilation.  Crit Care Med. 2003;  31 S400-406
    Google Scholar
  • 111 Tsevat J, Cook E F, Green M L. et al . Health values of the seriously ill. SUPPORT investigators.  Ann Intern Med. 1995;  122 514-520
    Google Scholar
  • 112 Frankl D, Oye R K, Bellamy P E. Attitudes of hospitalized patients toward life support: a survey of 200 medical inpatients.  Am J Med. 1989;  86 645-648
    CrossrefGoogle Scholar
  • 113 Garrett J M, Harris R P, Norburn J K. et al . Life-sustaining treatments during terminal illness: who wants what?.  J Gen Intern Med. 1993;  8 361-368
    Google Scholar
  • 114 Carmel S, Mutran E. Preferences for different life-sustaining treatments among elderly persons in Israel.  J Gerontol B Psychol Sci Soc Sci. 1997;  52 S97-102
    Google Scholar
  • 115 Wrosch C, Scheier M F. Personality and quality of life: the importance of optimism and goal adjustment.  Qual Life Res. 2003;  12 (Suppl 1) 59-72
    CrossrefGoogle Scholar
  • 116 Sloan R P, Bagiella E, VandeCreek L. et al . Should physicians prescribe religious activities?.  N Engl J Med. 2000;  342 1913-1916
    CrossrefGoogle Scholar
  • 117 Tulsky J A, Fischer G S, Rose M R. et al . Opening the black box: how do physicians communicate about advance directives?.  Ann Intern Med. 1998;  129 441-449
    CrossrefGoogle Scholar
  • 118 Brett A S. Limitations of listing specific medical interventions in advance directives.  JAMA. 1991;  266 825-828
    CrossrefGoogle Scholar
  • 119 Gillick M R. A broader role for advance medical planning.  Ann Intern Med. 1995;  123 621-624
    Google Scholar
  • 120 Hanson L C, Tulsky J A, Danis M. Can clinical interventions change care at the end of life?.  Ann Intern Med. 1997;  126 381-388
    Google Scholar
  • 121 Rosenfeld K E, Wenger N S, Kagawa-Singer M. End-of-life decision making: a qualitative study of elderly individuals.  J Gen Intern Med. 2000;  15 620-625
    CrossrefGoogle Scholar
  • 122 Pearlman R A, Cain K C, Patrick D L. et al . Insights pertaining to patient assessments of states worse than death.  J Clin Ethics. 1993;  4 33-41
    Google Scholar
  • 123 Doukas D J, McCullough L B. The values history. The evaluation of the patient’s values and advance directives.  J Fam Pract. 1991;  32 145-153
    Google Scholar
  • 124 Patrick D L, Pearlman R A, Starks H E. et al . Validation of preferences for life-sustaining treatment: implications for advance care planning.  Ann Intern Med. 1997;  127 509-517
    Google Scholar
  • 125 Fried T R, Bradley E H, Towle V R. et al . Understanding the treatment preferences of seriously ill patients.  N Engl J Med. 2002;  346 1061-1066
    CrossrefGoogle Scholar
  • 126 Danis M, Mutran E, Garrett J M. et al . A prospective study of the impact of patient preferences on life-sustaining treatment and hospital cost.  Crit Care Med. 1996;  24 1811-1817
    Google Scholar
  • 127 Carr K, Coakley J H, Waldmann C. et al .Aftercare programme - where, when, how and who?. Griffiths RD, Jones C Intensive care aftercare Oxford; Butterworth-Heinemann 2002: 67-129
    Google Scholar
  • 128 Jones C, Skirrow P, Griffiths R D. et al . Rehabilitation after critical illness: a randomized, controlled trial.  Crit Care Med. 2003;  31 2456-2461
    CrossrefGoogle Scholar
  • 129 Griffiths R D, Jones C. Intensive Care ­Aftercare. Butterworth-Heinemann, 2002. 
    Google Scholar

PD Dr. med. Markus Wehler

Medizinische Klinik I mit Poliklinik der Universität Erlangen-Nürnberg

Ulmenweg 18

91054 Erlangen

Email: markus.wehler@med1.imed.uni-­erlangen.de

      >