title: Impact of Sedation on Cognitive Function in Mechanically Ventilated Patients.
abstract: The practice of sedation dosing strategy in mechanically ventilated patient has a profound effect on cognitive function. We conducted a comprehensive review of outcome of sedation on mental health function in critically ill patients on mechanical ventilation in the intensive care unit (ICU). We specifically evaluated current sedative dosing strategy and the development of delirium, post-traumatic stress disorders (PTSDs) and agitation. Based on this review, heavy dosing sedation strategy with benzodiazepines contributes to cognitive dysfunction. However, outcome for mental health dysfunction is mixed in regard to newer sedatives agents such as dexmedetomidine and propofol. Moreover, studies that examine the impact of sedatives for persistence of PTSD/delirium and its long-term cognitive and functional outcomes for post-ICU patients are frequently underpowered. Most studies suffer from low sample sizes and methodological variations. Therefore, larger randomized controlled trials are needed to properly assess the impact of sedation dosing strategy on cognitive function.
authors.affiliation: VA Western New York Healthcare System, Division of Critical Care Medicine, Department of Anesthesiology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA. jahan.porhomayon@va.gov.|VA Medical Center, Rm 203C, 3495 Bailey Ave, Buffalo, NY, 14215, USA. jahan.porhomayon@va.gov.
authors.forename: Jahan
authors.initials: J
authors.lastname: Porhomayon
authors.affiliation: VA Western New York Healthcare System, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: El-Solh
authors.affiliation: Department of Science, MCC College, University at Buffalo, Rochester, NY, USA.
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Adlparvar
authors.affiliation: VA Western New York Healthcare System, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Jaoude
authors.affiliation: VA Western New York Healthcare System, Division of Cardiothoracic Anesthesia and Pain Medicine, Department of Anesthesiology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
authors.forename: Nader D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D017109:Akathisia, Drug-Induced / Q000453:epidemiology / Q000209:etiology; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D003422:Critical Care; D003693:Delirium / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D012121:Respiration, Artificial; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000139:chemically induced / Q000453:epidemiology
chemical_list: D006993:Hypnotics and Sedatives; D001569:Benzodiazepines
keywords: Anxiety; Cognitive function; Delirium; Mechanical ventilation; Post-traumatic stress disorder; Sedation