Neurologic changes during critical illness: brain imaging findings and neurobehavioral outcomes.
Encephalopathy and other neurologic morbidities are common in critical illness, sepsis, and prolonged mechanical ventilation. We assessed structural changes on brain imaging and neuropsychological outcomes in critically ill patients who developed neurological changes during their intensive care unit (ICU) stay. Patients who underwent brain imaging for neurological changes were included in the study. Medical, neuroradiological, and outcome data were obtained from patient medical records. Sixty-four patients underwent brain imaging for neurological changes. Forty-one (64%) patients had abnormalities on brain imaging. There were no differences for age, hospital length of stay, ICU length of stay, duration of mechanical ventilation or APACHE II scores for patients with normal compared to abnormal brain imaging. Cognitive impairments occurred in 48% of survivors and 6% developed psychiatric disorders. Our study demonstrates that abnormalities on brain imaging are common in critically ill patients. We also confirm previous findings that survivors of critical illness have cognitive impairments post-ICU discharge. This study further illustrates the adverse effects of critical illness on the brain and highlights the need for additional research in this emerging area.
Suchyta
Mary R
MR
Department of Medicine, Pulmonary and Critical Care Division, LDS Hospital, Salt Lake City, UT, USA.
Jephson
Al
A
Hopkins
Ramona O
RO
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D003072:Cognition Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D016638:Critical Illness / Q000401:mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed; D055815:Young Adult