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Cognitive sequelae in acute respiratory distress syndrome patients with and without recall of the intensive care unit

Published online by Cambridge University Press:  18 May 2007

MICHAEL J. LARSON
Affiliation:
Psychology Department, Brigham Young University, Provo, Utah Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
LINDELL K. WEAVER
Affiliation:
Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City, Utah University of Utah School of Medicine, Salt Lake City, Utah
RAMONA O. HOPKINS
Affiliation:
Psychology Department, Brigham Young University, Provo, Utah Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City, Utah Neuroscience Center, Brigham Young University, Provo, Utah

Abstract

Some critically ill patients have dramatic recollections of the intensive care unit (ICU), whereas 23–50% have little or no recollection of their ICU stay. In addition, cognitive impairments are common following critical illness and ICU treatment. Little is known regarding the relationship between cognitive sequelae and ICU recall. We assessed recall of the ICU and its relationship to cognitive functioning at hospital discharge and 1 and 2 years after discharge in 70 consecutive acute respiratory distress syndrome (ARDS) patients. Seventeen patients (24%) had no recall of the ICU. Patients without ICU recall had increased rates of cognitive sequelae at hospital discharge and 1-year follow-up compared with the ICU recall group. Patients without ICU recall had a greater magnitude of cognitive impairments at hospital discharge, but not at 1- or 2-year follow-up. Profile analysis showed significant group differences in general intellectual functioning, executive function, processing speed, and spatial skills at hospital discharge, but not at 1- or 2-year follow-up. Estimated premorbid intelligence scores were inversely related to the magnitude of cognitive sequelae, suggesting greater “cognitive reserve” in patients with fewer cognitive decrements. (JINS, 2007, 13, 595–605.)

Type
Research Article
Copyright
© 2007 The International Neuropsychological Society

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References

REFERENCES

Alexander, G.E., Furey, M.L., Grady, C.L., Pietrini, P., Brady, D.R., Mentis, M.J., & Schapiro, M.B. (1997). Association of premorbid intellectual function with cerebral metabolism in Alzheimer's disease: Implications for the cognitive reserve hypothesis. American Journal of Psychiatry, 154, 165172.Google Scholar
Al-Saidi, F., McAndrews, M.P., Cheunt, A.M., Tansey, C.M., Matte-Martyn, A., Diaz-Granadoes, N., & Herridge, M.S. (2003). Neuropsychological sequelae in ARDS survivors. American Journal of Respiratory and Critical Care Medicine, 167, A737.Google Scholar
Angus, D.C., Musthafa, A.A., Clermont, G., Griffin, M.F., Linde-Zwirble, W.T., Dremisizov, T., & Pinsky, M.R. (2001). Quality-adjusted survival in the first year after the acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine, 163, 13891394.Google Scholar
Ashbaugh, D.G., Bigelow, D.B., Petty, T.L., & Levine, B.E. (1967). Acute respiratory distress in adults. Lancet, 2, 319323.Google Scholar
Beck, A.T. (1987). Beck Depression Inventory Manual. San Antonio, TX: Psychology Corporation.
Beck, A.T. & Steer, R.A. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: Psychology Corporation.
Bergbom-Engberg, I. & Haljamea, H. (1989a). Assessment of patients' experience of discomforts during respirator therapy. Critical Care Medicine, 17, 10681072.Google Scholar
Bergbom-Engberg, I. & Haljamea, H. (1989b). Patient experiences during respirator treatment—reason for positive-pressure ventilation treatment and patient awareness in the intensive care unit. Critical Care Medicine, 17, 2225.Google Scholar
Capuzzo, M., Pinamonti, A., Cingolani, E., Grassi, L., Bianconni, M., Contu, P., Gritti, G., & Alvisi, R. (2001). Analgesia, sedation, and memory of intensive care. Journal of Critical Care, 16, 8389.Google Scholar
Daffurn, K., Bishop, G.F., Hillman, K.M., & Bauman, A. (1994). Problems following discharge after intensive care. Intensive Critical Care Nursing, 10, 244251.Google Scholar
Gale, S.D. & Hopkins, R.O. (2004). Effects of hypoxia on the brain: Neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea. Journal of the International Neuropsychological Society, 10, 6071.Google Scholar
Gale, S.D., Hopkins, R.O., Weaver, L.K., Walker, J.M., Bigler, E.D., & Cloward, T.V. (2000). Hippocampal atrophy following sleep apnea and carbon monoxide poisoning: Similarities and differences. Journal of the International Neuropsychological Society, 10, 6071.Google Scholar
Geffen, G., Moar, K.J., O'Hanlon, A.P., Clark, C.R., & Geffen, L.B. (1990). Performance measures of 16- to 86-year old males and females on the Auditory Verbal Learning Test. Clinical Neuropsychologist, 4, 4563.Google Scholar
Goldman, L.S. & Kimball, C.P. (1987). Depression in intensive care units. International Journal of Psychiatry and Medicine, 17, 201212.Google Scholar
Gordon, S.M., Jackson, J.C., Ely, E.W., Burger, C., & Hopkins, R.O. (2004). Clinical identification of cognitive impairment in ICU survivors: Insights for intensivists. Intensive Care Medicine, 30, 19972008.Google Scholar
Granberg, A., Bergbom-Engberg, I., & Lunberg, D. (1998). Patients' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome: Part I. Intensive Critical Care Nursing, 14, 294307.Google Scholar
Granja, C., Lopes, A., Moreira, S., Dias, C., Costa-Pereira, A., Carneiro, A., & JMIP Study Group. (2005). Patients' recollections of experiences in the intensive care unit may affect their quality of life. Critical Care, 9, 96109.Google Scholar
Green, A. (1996). An exploratory study of patients' memory recall of their stay in an adult intensive therapy unit. Intensive and Critical Care Nursing, 12, 131137.Google Scholar
Hall-Lord, M., Larsson, G., & Bostrom, I. (1994). Elderly patients' experiences of pain and distress in intensive care: A grounded theory study. Intensive Critical Care Nursing, 10, 133141.Google Scholar
Heaton, R.K., Grant, I., & Matthews, C.G. (1991). Comprehensive Norms for an Expanded Halstead-Reitan Battery: Demographic Corrections, Research Findings, and Clinical Applications. Odessa, TX: Psychological Assessment Resources.
Holland, C., Cason, C.L., & Prater, L.R. (1997). Patient's recollection in critical care. Dimensions in Critical Care Nursing, 16, 132141.Google Scholar
Hopkins, R.O. & Brett, S. (2005). Chronic neurocognitive effects of critical illness. Current Opinions in Critical Care, 11, 369375.Google Scholar
Hopkins, R.O. & Jackson, J.C. (2006). Long-term neurocognitive function after critical illness. Chest, 130, 869878.Google Scholar
Hopkins, R.O., Weaver, L.K., Collingridge, D., Parkinson, R.B., Chan, K.J., & Orme, J.F. (2005). Two year cognitive, emotional, and quality of life outcomes in acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine, 171, 340347.Google Scholar
Hopkins, R.O., Weaver, L.K., Pope, D., Orme, J.F., Bigler, E.D., & Larson-Lohr, V. (1999). Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome. American Journal of Respiratory Critical Care Medicine, 160, 5056.Google Scholar
Jackson, J.C., Gordon, S.M., Hart, R.P., Hopkins, R.O., & Ely, E.W. (2004). The association between delirium and cognitive decline: A review of the empirical literature. Neuropsychology Review, 14, 8798.Google Scholar
Jackson, J.C., Hart, R.P., Gordon, S.M., Shintani, A., Truman, B., May, L., & Ely, E.W. (2003). Six-month neuropsychological outcome of medical intensive care unit patients. Critical Care Medicine, 31, 12261234.Google Scholar
Jones, C., Griffiths, R.D., & Humphris, G. (2000). Disturbed memory and amnesia related to intensive care. Memory, 8, 7994.Google Scholar
Jones, C., Griffiths, R.D., Humphris, G., & Skirrow, P.M. (2001). Memory, delusions, and the development of posttraumatic stress disorder-related symptoms after intensive care. Critical Care Medicine, 29, 573580.Google Scholar
Jones, C., Griffiths, R.D., Macmillan, R., & Palmer, T.E.A. (1994). Psychological problems occurring after intensive care. British Journal of Intensive Care, 2, 4653.Google Scholar
Knaus, W.A., Draper, E.A., Wagner, D.P., & Zimmerman, J.E. (1985). APACHE II: A severity of disease classification system. Critical Care Medicine, 13, 818829.Google Scholar
Leur, J.P., Zwaveling, J.H., Loef, B.G., & Schans, C.P. (2003). Patient recollection of airway suctioning in the ICU: Routine versus minimally invasive procedure. Intensive Care Medicine, 29, 433436.Google Scholar
Lof, L., Berggren, L., & Ahlstrom, G. (2006). Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay–3 and 12 months after discharge. Intensive Critical Care Nursing, 22, 154166.Google Scholar
Magarey, J.M. & McCutcheon, H.H. (2005). ‘Fishing with the dead’–Recall of memories from the ICU. Intensive and Critical Care Nursing, 21, 344354.Google Scholar
McCartney, J.R. & Boland, R.J. (1994). Anxiety and delirium in the intensive care unit. Critical Care Clinics, 10, 673680.Google Scholar
McKegney, F.P. (1966). The intensive care syndrome. Connecticut Medicine, 30, 633636.Google Scholar
Meyers, J.E. & Meyers, K.R. (1995). Rey Complex Figure Test and Recognition Trial. Lutz, FL: PAR Inc.
Mittenberg, W., Burton, D.B., Darrow, E., & Thompson, G.B. (1992). Normative data for the Wechsler Memory Scale-Revised. Psychological Assessment, 4, 363368.Google Scholar
Orme, J.F., Romney, J.S., Hopkins, R.O., Pope, D., Chan, K.J., Thomsen, G., Crapo, R.O., & Weaver, L.K. (2003). Pulmonary function and health-related quality of life in survivors of acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine, 167, 690694.Google Scholar
Rothenhausler, H.B., Ehrentraut, S., Stoll, C., Schelling, G., & Kapfhammer, H.P. (2001). The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: Results of an exploratory study. General Hospital Psychiatry, 23, 9096.Google Scholar
Rundshagen, I., Schnabel, K., & Wegner, S.A.E. (2002). Incidence of recall, nightmare, and hallucination during analgosedation in intensive care. Intensive Care Medicine, 28, 3843.Google Scholar
Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7, 273295.Google Scholar
Schelling, G., Stoll, C., Haller, M., Briegle, J., Manert, W., Hummel, T., Lenhart, A., Heyduck, M., Polasek, J., Meier, M., Perub, U., Bullinger, M., Schuffel, W., & Klaus, P. (1998). Health-related quality of life and post-traumatic stress disorder in survivors of the acute respiratory distress syndrome. Critical Care Medicine, 26, 651659.Google Scholar
Schelling, G., Stoll, C., Vogelmeier, C., Himmel, T., Behr, J., Kapfhammer, H.P., Rothenhausler, H.B., Haller, M., Durst, K., Drausneck, T., & Briegel, J. (2000). Pulmonary function and health related quality of life in a sample of long-term survivors of the acute respiratory distress syndrome. Intensive Care Medicine, 26, 13041311.Google Scholar
Schmand, B., Smit, J.H., Geerlings, M.I., & Lindeboom, J. (1997). The effects of intelligence and education on the development of dementia. A test of the brain reserve hypothesis. Psychological Medicine, 27, 13371344.Google Scholar
Schmitz, R., Lantin, M., & White, A. (1998). Future needs in pulmonary and critical care medicine. Cambridge: ABT.
Scott, J.G., Krull, K.R., Williamson, D.J.G., Adams, R.L., & Iverson, G.L. (1997). Oklahoma premorbid intelligence estimation (OPIE): Utilization in clinical samples. Clinical Neuropsycholgy, 11, 146154.Google Scholar
Simini, B. (1999). Patients' perceptions of intensive care. Lancet, 9178, 571572.Google Scholar
Skodol, A.E. (1999). Anxiety in the medically ill: Nosology and principles of differential diagnosis. Seminars in Clinical Neuropsychiatry, 4, 6471.Google Scholar
Stern, Y., Albert, S., Tang, M., & Tsai, W. (1999). Rate of memory decline in AD is related to education and occupation: Cognitive reserve? Neurology, 53, 19421947.Google Scholar
Stern, Y., Alexander, G.E., Prohovnik, I., Stricks, L., Link, B., Lennon, M.C., & Mayeux, R. (1995). Relationships between lifetime occupation and parietal flow: Implications for a reserve against Alzheimer's disease pathology. Neurology, 45, 5560.Google Scholar
Stevens, J. (1996). Applied multivariate statistics for the social sciences (3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.
Sukantarat, K.T., Burgess, P.W., Williamson, R.C.N., & Brett, S. (2005). Prolonged cognitive dysfunction after critical illness. Anaesthesia, 60, 847853.Google Scholar
Swaiss, I.G. & Badran, I. (2004). Discomfort, awareness and recall in the intensive care-still a problem? Middle Eastern Journal of Anesthesiology, 17, 951958.Google Scholar
Tabachnik, B.G. & Fidell, L.S. (2001). Using multivariate statistics (4th ed.). Needham Heights, MA: Allyn and Bacon.
The Acute Respiratory Distress Syndrome Network. (2000). Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. New England Journal of Medicine, 342, 13011308.Google Scholar
Turner, J.S., Briggs, S.J., Springhorn, H.E., & Potgieter, P.D. (1990). Patients' recollection of intensive care unit experience. Critical Care Medicine, 18, 966968.Google Scholar
Weaver, L.K., Hopkins, R.O., Chan, K.J., Churchill, S., Elliott, C.G., Clemmer, T., Orme, J.F., Thomas, F.O, & Morris, A.H. (2002). Hyperbaric oxygen for acute carbon monoxide poisoning. New England Journal of Medicine, 347, 10571067.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale-Revised. San Antonio, TX: The Psychological Corporation.
White, J., Hopkins, R.O., Glissmeyer, E.W., Kitterman, N., & Elliott, C.G. (2006). Cognitive, emotional, and quality of life outcomes in patients with pulmonary arterial hypertension. Respiratory Research, 7, 55.Google Scholar