ICU patients with non-brain injury may have undetected cognitive dysfunction

A new study led by Western University and the Lawson Health Research Institute found that most patients admitted to intensive care units (ICUs) for non-brain lesions or conditions also suffer from some degree of dysfunction. linked cognitive which in most cases is not detected. .

The results were published today in the influential scientific journal, PLOS ONE.

Many patients stay at the ICU for reasons that have nothing to do with a known brain injury, and most health care providers and caregivers have no evidence to believe that There is a problem with the brain. For example, a patient may have suffered a traumatic injury that does not affect the brain, but still requires respiratory badistance to allow surgeons to repair damaged organs, heart or lung problems, a serious infection, or a serious infection. . may simply be recovering from surgery such as an organ transplant that has nothing to do with the brain.

For the study, Western researchers from the Schulich School of Medicine & Dentistry and the Brain and Mind Institute and Lawson researchers evaluated 20 patients at their exit from the ICU and each patient had detectable cognitive deficits in at least two areas of cognitive investigation, including memory, attention, decision making and reasoning. Again, this despite the fact that at first sight they had no obvious brain injury.

The discovery was made using online tests, developed by renowned Western neuroscientist Adrian Owen and his teams at Brain and Mind Institute and BrainsCAN, originally designed to examine the cognitive abilities of patients as a result of 39, brain injury, but used for this purpose. cognitive deficits in people who have spent time in an intensive care unit without diagnosed brain injury.

"Many people spend an intensive care unit following a brain injury and, of course, often suffer from deficits in memory, attention, decision-making and other cognitive functions," explains Owen, a professor at Schulich Medicine & Dentistry. . "In this study, we were interested in seeing how patients did not have specific brain damage after leaving the intensive care unit.The results were amazing."

Why cognitive ability decreases even when non-brain related visits to the USI probably vary from one patient to another, but Dr. Kimia Honarmand of Schulich Medicine & Dentistry says the lesson to be learned is that many conditions affect the functioning of the brain, even if they are not directly involving the brain.

"If you have trouble breathing, your brain may be deprived of oxygen.If you have a serious infection, the resulting inflammation may affect brain function.If you undergo major surgery, have procedures that can affect your breathing, which can in turn affect oxygen delivery to the brain, "says Dr. Honarmand." What we showed here is that all or part of these events can lead to deficits in brain function that result in impairments of cognition. Healthy cognition is a determining factor in functional recovery. "

Dr. Marat Slessarev, a scientist at Lawson, explains that these findings may change the way the medical community treats incoming patients and, more importantly, outpatients after ICU visits.

"Historically, the clinical focus was solely on survival, but now we can start focusing on good survival," said Dr. Slessarev, badociate member of the Brain and Mind Institute and badistant professor at Schulich Medicine & Dentistry. "These sensitive tests will enable doctors to detect cognitive impairments and track cognitive performance over time, which is the first step in developing processes for optimizing brain recovery."