Long-term neuropsychological impairment is common in acute lung injury survivors

April 6, 2012

Cognitive and psychiatric impairments are common among long-term survivors of acute lung injury (ALI), and these impairments can be assessed using a telephone-based test battery, according to a new study.

"Neuropsychological impairment is increasingly being recognized as an important outcome among survivors of critical illness, but neuropsychological function in long-term ALI survivors has not been assessed in a multi-center trial, and evidence on the etiology of these impairments in ALI survivors is limited," said lead author Mark E. Mikkelsen, MD, MSCE, assistant professor of medicine at the University of Pennsylvania. "To overcome the constraints of in-person assessment, we developed a telephone battery of standardized neuropsychological tests that could be administered by a non-expert and used it to assess a subset of 122 ALI survivors from the Acute Clinical Trials Network Fluid and Catheter Treatment Trial."

"We found that neuropsychological function can be assessed by telephone in a multi-center trial, and that long-term neuropsychological impairment is common in these patients," continued Dr. Mikkelsen. "We also found that hypoxemia was associated with an increased risk for long-term cognitive and psychiatric impairment."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and .

The test battery was administered to study subjects at two and 12 months after discharge from the hospital. At 12 months, memory, verbal fluency, and executive function (a set of cognitive abilities necessary for effective daily functioning) were impaired in 13, 16, and 49 percent of survivors, respectively, while cognitive impairment (defined as impairment in memory, , and/or executive function) was found in 41 of 75 survivors (55 percent). Depression, post-traumatic stress disorder, and anxiety were found in 36, 39, and 62 percent of long-term survivors.

Enrollment in a conservative fluid-management strategy was significantly associated with the development of cognitive impairment, and lower partial pressure of arterial oxygen during the trial was associated with a significantly increased risk of both cognitive and psychiatric impairment. "Although it is plausible that use of a conservative fluid-management strategy was associated with an increased risk for long-term cognitive impairment," Dr. Mikkelsen said, "based on the small sample size and an unclear mechanism, this finding warrants confirmation."

The study had a few limitations, including its small sample size and the use of self-report for several measures.

"Our study confirms earlier research showing that cognitive and psychiatric morbidity are common among long-term survivors of ALI," concluded Dr. Mikkelsen. "We are indebted to the NIH for supporting EA-PAC, the parent study of the present study, and for recognizing the importance of assessing a multitude of long-term outcomes to properly understand survivorship and ultimately to improve the lives of critically ill survivors."

Explore further: Depressive symptoms and impaired physical function are frequent and long-lasting after ALI

Related Stories

Depressive symptoms and impaired physical function are frequent and long-lasting after ALI

December 9, 2011
Depressive symptoms and impaired physical function were common and long-lasting during the first two years following acute lung injury (ALI), according to a new study from Johns Hopkins University School of Medicine. Depressive ...

Sleep issues contribute to cognitive problems in childhood cancer survivors

April 11, 2011
A new analysis has found that childhood cancer survivors often suffer from sleep problems and fatigue, which negatively impact their attention and memory. Published early online in Cancer, a peer-reviewed journal of the American ...

Breast cancer survivors struggle with cognitive problems several years after treatment

December 12, 2011
A new analysis has found that breast cancer survivors may experience problems with certain mental abilities several years after treatment, regardless of whether they were treated with chemotherapy plus radiation or radiation ...

Inactivity and obesity relate to cognitive impairment in lupus

February 29, 2012
(HealthDay) -- Physical inactivity and obesity are associated with impaired cognitive function, especially executive functions, in women with systemic lupus erythematosus (SLE), according to research published online Feb. ...

Recommended for you

Addressing superbug resistance with phage therapy

August 16, 2017
International research involving a Monash biologist shows that bacteriophage therapy – a process whereby bacterial viruses attack and destroy specific strains of bacteria - can be used successfully to treat systemic, multidrug ...

Can previous exposure to west Nile alter the course of Zika?

August 15, 2017
West Nile virus is no stranger to the U.S.-Mexico border; thousands of people in the region have contracted the mosquito-borne virus in the past. But could this previous exposure affect how intensely Zika sickens someone ...

Compounds in desert creosote bush could treat giardia and 'brain-eating' amoeba infections

August 15, 2017
Researchers at Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California San Diego and the University of Colorado Anschutz Medical Campus have found that compounds produced by the creosote bush, a ...

New malaria analysis method reveals disease severity in minutes

August 11, 2017
Left untreated, malaria can progress from being mild to severe—and potentially fatal—in 24 hours. So researchers at the University of British Columbia developed a method to quickly and sensitively assess the progression ...

Drug trial shows promise for deadly neurological disorder

August 10, 2017
Results of a small clinical trial show promise for treating a rare neurodegenerative condition that typically kills those afflicted before they reach age 20. The disease, called Niemann-Pick type C (NPC), causes cholesterol ...

Test uses nanotechnology to quickly diagnose Zika virus

August 10, 2017
Washington University in St. Louis researchers have developed a test that quickly detects the presence of Zika virus in blood.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.