Home' Trinidad and Tobago Guardian : October 10th 2013 Contents According to researchers, the longer patients had been delirious in the ICU, the
worse their thinking problems tended to be months after discharge.
body & soul
Guardian www.guardian.co.tt Thursday, October 10, 2013
Critically-ill people who end up spending days in
an intensive care unit (ICU) often develop thinking
and memory problems, according to a new study.
Even when people recover from their physical illness,
those problems can persist for more than a year after
their hospital stay, researchers said.
They found ICU patients who were delirious---
severely confused and unable to focus---were especially
likely to go on to have thinking and memory prob-
"The longer you are delirious, the more likely you
are to have long-term cognitive impairment that looks
like Alzheimer s disease or traumatic brain injury," Dr
Wes Ely of the Vanderbilt University Medical Center
in Nashville, Tennessee, told Reuters Health.
"For a long time, we thought delirium was just
something that happened because people were in the
ICU and that, as soon as they got out of the ICU,
they would be okay," Dr Karin Neufeld, a psychiatrist
at Johns Hopkins University School of Medicine in
Baltimore, told Reuters Health.
Now, she said, doctors are realising being delirious
could be a sign that a patient is more severely ill.
"We need to redouble our efforts to reduce the
number of days people are delirious and prevent it if
we can," said Neufeld, who was unconnected with
Doctors have known for years that certain patients
are prone to some degree of thinking problems after
For example, one study from last year found almost
half of heart surgery patients developed delirium and
their minds often remained dulled for a year.
What is new about this study is that cognitive prob-
lems were seen among patients with a wide range of
illnesses, Neufeld said. However, she added, the people
were alike in one way: they were all very sick.
Ely and his team studied 821 people who ended up
in the ICU because of respiratory failure or shock.
Those patients were originally hospitalised for infec-
tions or lung or stomach problems. None were hos-
pitalised for brain-related issues such as strokes.
Nearly three-quarters of the patients became deliri-
ous during their ICU stay, typically for a few days at
Three months after leaving the hospital, 40 per
cent of them had thinking problems comparable to
someone with moderate traumatic brain injury, the
researchers found. And 26 per cent had cognitive
scores as low as someone with mild Alzheimer s dis-
The problems barely faded with time.
At the one-year mark, 34 percent of patients were
still functioning on the same level as someone with
moderate traumatic brain injury and 24 per cent at
the level of a person with mild Alzheimer s.
"Your odds are not great in terms of recovery," said
Ely. "Some will recover but most won t, and that is
The longer patients had been delirious in the ICU,
the worse their thinking problems tended to be months
after discharge, the researchers reported in the New
England Journal of Medicine.
They couldn t link those problems to any particular
medication and found that younger patients had risks
similar to the group as a whole.
"Perhaps the scariest piece of all is that 30- and
40-year-olds coming in with no pre-existing disease
are often leaving with profound cognitive impairment,"
Ely said in a statement.
Neufeld said keeping ICU patients pain-free but
away from sedatives as much as possible and getting
those who are able walking around can lessen delir-
"You can t eliminate the problem, but maybe you
can reduce it," Ely said.
He stressed that the findings should not discourage
people from getting the treatment they need.
What s most important, he said, is that people are
aware of these issues.
Even if people come into the hospital with no other
underlying health problems, "if they get crazy sick
and (end up) in an ICU, you have a new problem to
consider when they leave," Ely said.
"And if you didn t consider that, they re going to
go back out into the world and have a lot of dysfunction
in their life." (Reuters Health)
Study: Brain problems can
linger months after ICU stay
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