Study finds prolonged ICU sedation ups the risk of cognitive loss

There's No Substitute for Experience

Researchers from Vanderbilt University and the Tennessee Valley Veterans Affairs Geriatric Research Education and Clinical Center recently released the findings of a study that suggest those hospital patients with prolonged stays in the intensive care unit run the risk of mental impairment for some time after leaving the hospital. The thought is this is due to the fact that ICU patients are kept immobilized and heavily sedated in order to recover without pain and anxiety.

This study included 821 patients between the ages of 18 and 99 who had been admitted into the ICU. All of the patients suffered from respiratory failure or septic shock. Their median stay in the ICU was five days. Only 6 percent came in to the ICU with pre-existing mental impairment.

Of these 821 patients, 75 percent also developed delirium while in the hospital.

A year after their ICU stay, the cognitive function of these patients was evaluated. Of these patients, 34 percent had cognitive functioning scores similar to someone who suffered from a traumatic brain injury. Another 24 percent had similar scores to someone with mild Alzheimer's disease. In total, close to 80 percent had lower cognitive scores than what their age and level of education would have predicted.

In looking at the results of this study, the idea is that being sedated for a long time can trigger delirium or make the delirium worse. However, this is where many ICUs run into an issue as keeping the patients heavily sedated is standard protocol. As mentioned in the beginning of this post, 75 percent of the patients included in this study developed delirium while in the hospital.

In general though, this study points to the importance of modifying existing ICU protocols and offering more rehabilitative services to those who are discharged from the hospital. The hope is more attention being given to the issue now, could prevent mental impairment later.

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