title: [Acute and long-term cognitive consequences of treatment on intensive care units].
abstract: BACKGROUND
  Following treatment on the intensive care unit (ICU) patients often suffer from acute and long-term cognitive deficits. This is true for patients of all age groups but especially for elderly patients who have undergone surgery and develop postoperative delirium (POD) or postoperative cognitive decline (POCD). Both are associated with severe limitations in the quality of life and long-term outcome.
  
  
  OBJECTIVE
  Which acute and long-term cognitive effects develop in ICU survivors and how do they influence the outcome? How can POD and POCD be differentiated?
  
  
  METHODS
  A selective literature search was carried out.
  
  
  RESULTS
  Following surgery POCD can develop within days to weeks, may persist for weeks or months and can lead to problems in attentiveness even under conditions of inconspicuous consciousness. Remission is possible but may take up to more than 12 months. The POD is a phenomenon characterized by disturbances of consciousness and problems in attention, beginning acutely hours and days postoperatively, can persist for days to weeks and remission can be expected within a few days. While POD often has an organic cause, such as an infection, the pathogenesis of POCD has not been sufficiently elucidated.
  
  
  CONCLUSIONS
  Both POD and particularly POCD can lead to a deterioration of cognition following ICU treatment. As efficient treatment still has to be developed preventive methods, such as preoperative screening for risk factors, thorough planning of operative and anesthetic techniques and compensation of risk factors as well as providing assistance to patients, e. g. by a trained nurse should be implemented in the clinical routine more often than is presently the case.
authors.affiliation: Abt. für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Königin Elisabeth Herzberg gGmbH, Herzbergstr. 79, 10365, Berlin, Deutschland. t.kratz@keh-berlin.de.
authors.forename: T
authors.initials: T
authors.lastname: Kratz
authors.affiliation: Abt. für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Königin Elisabeth Herzberg gGmbH, Herzbergstr. 79, 10365, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Diefenbacher
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000523:psychology / Q000628:therapy*; D003693:Delirium / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units; D011183:Postoperative Complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
keywords: Cognitive deficits; Intensive care unit; Postoperative cognitive dysfunction; Postoperative delirium; Risk factors