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机器人技术为危重病幸存者的神经认知功能提供了客观和可量化的指标:一项可行性研究。

Robotic technology provides objective and quantifiable metrics of neurocognitive functioning in survivors of critical illness:A feasibility study.

机构信息

Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.

Department of Critical Care Medicine, Queen's University, Kingston Health Sciences Centre, Kingston, ON, Canada.

出版信息

J Crit Care. 2018 Dec;48:228-236. doi: 10.1016/j.jcrc.2018.09.011. Epub 2018 Sep 12.

Abstract

PURPOSE

To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS).

MATERIALS AND METHODS

Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot.

RESULTS

At 3- and 12-months after ICU discharge, 28/70 (40%) and 22/70 (31%) returned for follow-up testing, respectively. Prominent reasons for declining testing at 3- and 12-months included: not interested (40% and 38%) and health complications (31% and 31%). The majority of returning participants completed all tasks (96%-100%) and 100% of available data was recorded. On the RBANS, 54% (3 months) and 32% (12 months) of individuals were impaired in visuospatial/constructional skills. Similarly, the KINARM assessments demonstrated that 56% of individuals had visuospatial/executive dysfunction at 3 months, and 40% had impairment at 12 months. Individual scores indicated substantial variability.

CONCLUSIONS

We demonstrated that it was feasible to quantify neurological dysfunction among participants that returned for follow-up testing. However, future investigations will need to implement multiple retention strategies.

TRIAL REGISTRATION

This trial is registered on clinicaltrials.gov (Identifier: NCT02344043), retrospectively registered January 8, 2015.

摘要

目的

评估使用综合多模态数据采集策略来描述重症监护后综合征(PICS)的可行性。

材料和方法

纳入标准为入住 ICU 并接受>24 h 有创机械通气和/或需要血管加压支持的成年患者。我们在 ICU 出院后 3 个月和 12 个月时使用重复神经心理状态评估量表(RBANS)和 KINARM 机器人评估认知和感觉运动功能。

结果

在 ICU 出院后 3 个月和 12 个月时,分别有 28/70(40%)和 22/70(31%)名患者返回进行随访测试。拒绝在 3 个月和 12 个月时进行测试的主要原因包括:不感兴趣(40%和 38%)和健康并发症(31%和 31%)。大多数返回的参与者完成了所有任务(96%-100%),并记录了 100%的可用数据。在 RBANS 上,54%(3 个月)和 32%(12 个月)的个体在视空间/结构技能方面受损。同样,KINARM 评估表明,56%的个体在 3 个月时存在视空间/执行功能障碍,40%的个体在 12 个月时存在障碍。个体分数显示出很大的变异性。

结论

我们证明了对返回进行随访测试的参与者进行量化神经功能障碍是可行的。然而,未来的研究需要实施多种保留策略。

试验注册

本试验在 clinicaltrials.gov(标识符:NCT02344043)上注册,于 2015 年 1 月 8 日进行了回顾性注册。

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