A new study suggests that an extended stay in the ICU may be bad for the brain as it may cause negative effects such as cognitive deterioration.
Dr. Pratik Pandharipande, lead author of the study from Vanderbilt University, said that attending physicians at the ICU need to be mindful of the mental capacities of their patients. They don't need to keep them sedated to lessen cognitive deterioration. Previously doctors have generally practiced treating patients by considering all other factors except their cognitive impact.
The new research monitored seriously ill patients who stayed in the intensive care units in hospitals-- the Vanderbilt Medical Center and St. Thomas Hospital -- between March 2007 and May 2010. There were 382 critical patients subjected to cognitive tests one year after they were discharged because of dementia symptoms.
It was found that around 33 percent of the subjects had decreased mental capabilities that are manifested in moderate cases of brain trauma. About 25 percent of them showed cognitive deterioration quite similar to mild Alzheimer's.
The researchers believe that allowing critically ill patients to stay in drug-assisted comatose can actually make them more delirious. They cautioned that the delirious time spent in ICU is proportionately linked to the level of risk the patient has to have prolonged dementia upon leaving the hospital.
"In a nutshell, the simplified version of what these hospitals can be doing is they can make a culture shift in how they handle their sickest patients in the ICU," said Dr. Wes Ely, the senior author of the study and Vanderbilt professor of critical care told USA Today. "Instead of keeping them in drug-induced comas, they can keep them awake and alert even though they are on life support."
"We now know that making them not remember actually increases post-traumatic stress disorder and long-term cognitive impairment," he added.
ICU care is not just about focused treatment and making patients comfortable; it is also necessary for ICU health professionals to check and stimulate the patients' cognitive abilities. This will avoid higher risk of dementia and better living conditions after discharged from the hospital.
The study was published in the Oct. 2 issue of the New England Journal of Medicine.
