Interdepartmental Division of Critical Care Medicine, Toronto Western Hospital, Toronto, ON, Canada.
Crit Care Med. 2013 Sep;41(9 Suppl 1):S81-98. doi: 10.1097/CCM.0b013e3182a16946.
In contrast to other clinical outcomes, long-term cognitive function in critical care survivors has not been deeply studied. In this narrative review, we summarize the existing literature on the prevalence, mechanisms, risk factors, and prediction of cognitive impairment after surviving critical illness. Depending on the exact clinical subgroup, up to 100% of critical care survivors may suffer some degree of long-term cognitive impairment at hospital discharge; in approximately 50%, decrements in cognitive function will persist years later. Although the mechanisms of acquiring this impairment are poorly understood, several risk factors have been identified. Unfortunately, no easy means of predicting long-term cognitive impairment exists. Despite this barrier, research is ongoing to test possible treatments for cognitive impairment. In particular, the potential role of exercise on cognitive recovery is an exciting area of exploration. Opportunities exist to incorporate physical and cognitive rehabilitation strategies across a spectrum of environments (in the ICU, on the hospital ward, and at home, posthospital discharge).
与其他临床结果相比，重症监护幸存者的长期认知功能尚未得到深入研究。在这篇叙述性综述中，我们总结了现有文献中关于重症疾病后认知障碍的患病率、机制、危险因素和预测。根据确切的临床亚组，多达 100%的重症监护幸存者在出院时可能会出现一定程度的长期认知障碍；大约 50%的患者，认知功能的下降会持续数年。尽管获得这种损害的机制尚不清楚，但已经确定了一些危险因素。不幸的是，目前还没有简单的方法来预测长期认知障碍。尽管存在这一障碍，但仍在继续研究治疗认知障碍的可能方法。特别是，运动对认知恢复的潜在作用是一个令人兴奋的探索领域。有机会在一系列环境中（在 ICU 中、在医院病房中和出院后在家中）纳入身体和认知康复策略。
