Department of Medicine, Pulmonary and Critical Care Division, LDS Hospital, Salt Lake City, UT, USA.
Brain Imaging Behav. 2010 Mar;4(1):22-34. doi: 10.1007/s11682-009-9082-3. Epub 2009 Nov 12.
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.
脑病和其他神经系统疾病在危重病、脓毒症和长时间机械通气中很常见。我们评估了在重症监护病房（ICU）住院期间发生神经系统变化的危重病患者的脑影像学结构变化和神经心理学结果。对因神经系统变化而行脑影像学检查的患者进行了研究。从患者的病历中获取了医学、神经放射学和预后数据。64 名患者因神经系统变化而行脑影像学检查。41 名（64%）患者的脑影像学检查存在异常。与脑影像学正常的患者相比，脑影像学异常的患者在年龄、住院时间、ICU 住院时间、机械通气时间或 APACHE II 评分方面没有差异。幸存者中 48%存在认知障碍，6%发展为精神障碍。我们的研究表明，危重病患者的脑影像学异常很常见。我们还证实了先前的发现，即危重病幸存者在 ICU 出院后存在认知障碍。这项研究进一步说明了危重病对大脑的不良影响，并强调了在这一新兴领域需要进一步研究。
