Journal of the International Neuropsychological Society



Cognitive sequelae in acute respiratory distress syndrome patients with and without recall of the intensive care unit


MICHAEL J.  LARSON  a1 a2 , LINDELL K.  WEAVER  a3 a4 and RAMONA O.  HOPKINS  a1 a3 a5 c1
a1 Psychology Department, Brigham Young University, Provo, Utah
a2 Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
a3 Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City, Utah
a4 University of Utah School of Medicine, Salt Lake City, Utah
a5 Neuroscience Center, Brigham Young University, Provo, Utah

Article author query
larson mj   [PubMed][Google Scholar] 
weaver lk   [PubMed][Google Scholar] 
hopkins ro   [PubMed][Google Scholar] 

Abstract

Some critically ill patients have dramatic recollections of the intensive care unit (ICU), whereas 23–50% have little or no recollection of their ICU stay. In addition, cognitive impairments are common following critical illness and ICU treatment. Little is known regarding the relationship between cognitive sequelae and ICU recall. We assessed recall of the ICU and its relationship to cognitive functioning at hospital discharge and 1 and 2 years after discharge in 70 consecutive acute respiratory distress syndrome (ARDS) patients. Seventeen patients (24%) had no recall of the ICU. Patients without ICU recall had increased rates of cognitive sequelae at hospital discharge and 1-year follow-up compared with the ICU recall group. Patients without ICU recall had a greater magnitude of cognitive impairments at hospital discharge, but not at 1- or 2-year follow-up. Profile analysis showed significant group differences in general intellectual functioning, executive function, processing speed, and spatial skills at hospital discharge, but not at 1- or 2-year follow-up. Estimated premorbid intelligence scores were inversely related to the magnitude of cognitive sequelae, suggesting greater “cognitive reserve” in patients with fewer cognitive decrements. (JINS, 2007, 13, 595–605.)

(Received October 26 2006)
(Revised January 6 2007)
(Accepted January 8 2007)


Key Words: ARDS; Intensive care unit (ICU); Cognitive outcome; Cognitive reserve; Critical; Illness; Sequelae; Memory.

Correspondence:
c1 Correspondence and reprint requests to: Ramona O. Hopkins, Ph.D., Division of Critical Care Medicine, LDS Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143, USA. E-mail: ramona.hopkins@intermountainmail.com