'ICU Delirium' Affects Brain After Discharge
"Profound" cognitive problems often persist after a stay in the ICU, leaving patients with the equivalent of a blow to the head or early Alzheimer's disease, a study determined.
One year after discharge, 34% of patients had cognitive scores similar to those with moderate traumatic brain injury and 24% had the equivalent of mild Alzheimer's disease, Pratik Pandharipande, MD, MSCI, of Vanderbilt University Medical Center in Nashville, Tenn., and colleagues found.
The deficits were seen across ages and were strongly linked to duration of delirium in the ICU, the researchers reported in the Oct. 3 issue of the New England Journal of Medicine.
Physicians need to not only recognize that memory problems could stem from prior ICU stay but also proactively fight delirium in the ICU to prevent these deficits that keep patients from getting back to normal, Pandharipande told MedPage Today.
"For patients we know have cognitive impairment, we could try and have interventions such as cognitive therapy at the time of discharge or perhaps, if there are resources, even earlier just like we do physical therapy," he said.
"The public health effect of neurocognitive morbidity after critical illness is undeniable," said Margaret Herridge, MD, MPH, and Jill I. Cameron, PhD, both of the University of Toronto, who called the study's evidence unequivocal in an accompanying editorial.