Department of Intensive Care Medicine, University Medical Center Utrecht, Mail Stop F.06.149, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Intensive Care Med. 2013 Mar;39(3):376-86. doi: 10.1007/s00134-012-2784-9. Epub 2013 Jan 18.
There is increasing evidence that critical illness and treatment in an intensive care unit (ICU) may result in significant long-term morbidity. The purpose of this systematic review was to summarize the current literature on long-term cognitive impairment in ICU survivors.
PubMed/MEDLINE, CINAHL, Cochrane Library, PsycINFO and Embase were searched from January 1980 until July 2012 for relevant articles evaluating cognitive functioning after ICU admission. Publications with an adult population and a follow-up duration of at least 2 months were eligible for inclusion in the review. Studies in cardiac surgery patients or subjects with brain injury or cardiac arrest prior to ICU admission were excluded. The main outcome measure was cognitive functioning.
The search strategy identified 1,128 unique studies, of which 19 met the selection criteria and were included. Only one article compared neuropsychological test performance before and after ICU admission. The 19 studies that were selected reported a wide range of cognitive impairment in 4-62 % of the patients after a follow-up of 2-156 months.
The results of most studies of the studies reviewed suggest that critical illness and ICU treatment are associated with long-term cognitive impairment. Due to the complexity of defining cognitive impairment, it is difficult to standardize definitions and to reach consensus on how to categorize neurocognitive dysfunction. Therefore, the magnitude of the problem is uncertain.
越来越多的证据表明，重症疾病和重症监护病房（ICU）的治疗可能导致显著的长期发病率。本系统评价的目的是总结 ICU 幸存者长期认知障碍的现有文献。
从 1980 年 1 月至 2012 年 7 月，通过 PubMed/MEDLINE、CINAHL、 Cochrane 图书馆、PsycINFO 和 Embase 搜索评估 ICU 入住后认知功能的相关文章。符合纳入标准的研究为：纳入成年人，随访时间至少 2 个月。排除心脏手术患者或 ICU 入院前有脑损伤或心搏骤停的患者。主要结局指标为认知功能。
搜索策略确定了 1128 篇独特的研究，其中 19 篇符合选择标准并被纳入。只有一篇文章比较了 ICU 入住前后的神经心理测试表现。选择的 19 项研究报告了在 2-156 个月的随访后，4-62%的患者存在广泛的认知障碍。
大多数研究表明，重症疾病和 ICU 治疗与长期认知障碍有关。由于定义认知障碍的复杂性，难以标准化定义，并就如何分类神经认知功能障碍达成共识。因此，问题的严重程度尚不确定。
