Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome
Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome
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DOI：
10.1164/ajrccm.160.1.9708059
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发表时间：
1999-07-01
影响因子：
24.7
通讯作者：
Larson-Lohr, V
中科院分区：
文献类型：
--
作者：
Hopkins, RO;Weaver, LK;Larson-Lohr, V
急性呼吸窘迫综合征(ARDS)是一种以严重低氧血症为主要表现的急性呼吸衰竭疾病，病死率高。以前的ARDS预后研究评估了生存和/或肺功能作为主要预后变量。ARDS后的认知或心理后果尚未被描述，尽管ARDS患者可能因低氧血症或其他机制而面临脑损伤的风险。在目前的研究中，连续55名ARDS幸存者完成了一系列神经心理测试和问卷调查，内容涉及出院时和ARDS发病一年后的健康状况、认知和心理结果。在出院时，100%(55/55)的幸存者表现出认知和情感障碍，以及影响他们生活质量的健康状况问题。在ARDS后1年，55名患者中仍有17名(30%)表现出广泛性认知功能下降。55名患者中有43名(78%)有以下全部或至少一项症状：记忆力、注意力、注意力受损和/或心理处理速度减慢。ARDS后一年，相当一部分ARDS幸存者表现出健康状况受损和认知后遗症，这可能是由于低氧血症、血栓、炎症、药物毒性和/或其他原因。
Acute respiratory distress syndrome (ARDS) is a disease of acute respiratory failure manifested by severe hypoxemia with a high mortality rate. Previous outcome studies of ARDS have assessed survival and/or pulmonary function as the primary outcome variables. Cognitive or psychological outcomes following ARDS have not been described, despite the possibility that ARDS patients are at risk for brain injury through hypoxemia or other mechanisms. In the current study 55 consecutive ARDS survivors completed a battery of neuropsychological tests and questionnaires regarding health status, cognitive and psychological outcomes at the time of hospital discharge and 1 yr after onset of ARDS. At hospital discharge, 100% (55 of 55) of survivors exhibited cognitive and affective impairments, as well as problems with health status which affected their quality of life. At 1 yr after ARDS, 17 of 55 (30%) patients still exhibited generalized cognitive decline. Forty-three of 55 (78%) patients had all or at least one of the following: impaired memory, attention, concentration and/or decreased mental processing speed. One year after ARDS a substantial portion of ARDS survivors exhibit impaired health status and cognitive sequelae which may be due to hypoxemia, emboli, inflammation, drug toxicity, and/or other etiologies.