ICU sedation, delirium & recovery
Covert Critical Illness Encephalopathy: Impairments That Escape Detection by Guideline Recommended, Protocolized Assessments
Authors' conclusion
Substantial cognitive impairment is present among critically ill patients with no abnormalities detected by standard delirium and encephalopathy assessments.
Study context
- Population
- Critically ill ICU patients with negative Confusion Assessment Method for the ICU (CAM-ICU) screening, Richmond Agitation-Sedation Scale (RASS) 0 and Glasgow Coma Scale (GCS) 15 (alert, oriented, following commands, no delirium or subsyndromal delirium), ICUs implementing the SCCM ICU Liberation Bundleage 54 ± 16 years
- Participants
- 50 patients
- Outcome
- Cognitive impairment (≥1.5 SD worse than demographically adjusted means in ≥2 domains)
Methodological detailsrandom patient sampling
- Random patient sampling
Main finding
As reported in the abstract
- Patients meeting criterion for cognitive impairment
- 64%
- Executive functions (attention and inhibitory control) and processing speed 1.5 SD below population norm
- p < 0.01
- Working memory significantly but less severely impaired
- p < 0.01
- Cognitive flexibility significantly but less severely impaired
- p = 0.026
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Covert Critical Illness Encephalopathy: Impairments That Escape Detection by Guideline Recommended, Protocolized Assessments. Crit Care Med. Published 24 December 2024. doi:10.
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