Cited by 615Intensive Care Unit Cognitive DisordersRespiratory Support and MechanismsInfectious Encephalopathies and Encephalitis

The Adult Respiratory Distress Syndrome Cognitive Outcomes Study: Long-Term Neuropsychological Function in Survivors of Acute Lung Injury

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Mikkelsen, Mark E., Christie, Jason D., Lanken, Paul N., Biester, Rosette C., Thompson, B. Taylor, Bellamy, Scarlett L., Localio, A. Russell, Demissie, Ejigayehu +2 more·2012·American Journal of Respiratory and Critical Care Medicine

Abstract

Rationale: Cognitive and psychiatric morbidity is common and potentially modifiable after acute lung injury (ALI). However, practical measures of neuropsychological function for use in multicenter trials are lacking. Objectives: To determine whether a validated telephone-based neuropsychological test battery is feasible in a multicenter trial. To determine the frequency and risk factors for long-term neuropsychological impairment. Methods: As an adjunct study to the Acute Respiratory Distress Syndrome Clinical Trials Network Fluid and Catheter Treatment Trial, we assessed neuropsychological function at 2 and 12 months post–hospital discharge. Measurements and Main Results: Of 406 eligible survivors, we approached 261 to participate and 213 consented. We tested 122 subjects at least once, including 102 subjects at 12 months. Memory, verbal fluency, and executive function were impaired in 13% (12 of 92), 16% (15 of 96), and 49% (37 of 76) of long-term survivors. Long-term cognitive impairment was present in 41 of the 75 (55%) survivors who completed cognitive testing. Depression, post-traumatic stress disorder, or anxiety was present in 36% (37 of 102), 39% (40 of 102), and 62% (63 of 102) of long-term survivors. Enrollment in a conservative fluid-management strategy (P = 0.005) was associated with cognitive impairment and lower partial pressure of arterial oxygen during the trial was associated with cognitive (P = 0.02) and psychiatric impairment (P = 0.02). Conclusions: Neuropsychological function can be assessed by telephone in a multicenter trial. Long-term neuropsychological impairment is common in survivors of ALI. Hypoxemia is a risk factor for long-term neuropsychological impairment. Fluid management strategy is a potential risk factor for long-term cognitive impairment; however, given the select population studied and an unclear mechanism, this finding requires confirmation.

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Authors
Mikkelsen, M. E., Christie, J. D., Lanken, P. N., Biester, R. C., Thompson, B. T., Bellamy, S. L., Localio, A. R., Demissie, E., Hopkins, R. O., & Angus, D. C.
Affiliations
  • University of Pennsylvania (US)
  • Pulmonary, Allergy, and Critical Care Division, Department of Medicine
  • Philadelphia VA Medical Center (US)
  • Massachusetts General Hospital (US)
  • Center for Clinical Epidemiology and Biostatistics, and
  • Intermountain Medical Center (US)
  • Brigham Young University (US)
Corresponding author
Mikkelsen, Mark E.
Venue
American Journal of Respiratory and Critical Care Medicine
Published
2012-06
Volume
185
Issue
12
Pages
1307-1315
ISSN
  • 1073-449X (ISSN-L)
  • 1535-4970
OpenAlex
W2101436344
Cited by
615
References
68
Citations by year
2026: 21 · 2025: 42 · 2024: 41 · 2023: 43 · 2022: 55 · 2021: 81 · 2020: 59 · 2019: 43 · 2018: 40 · 2017: 40 · 2016: 44 · 2015: 32 · 2014: 35 · 2013: 28 · 2012: 11
FWCI
28.32
Type
journal article
Language
en
Open access
Locations
  • American Journal of Respiratory and Critical Care Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Thoracic Society
  • University of Pittsburgh
  • National Institutes of Health (n01hr016146-000, n01hr046058-006)
  • National Heart, Lung, and Blood Institute (T32HL07891, N01-HR46046-64, N01-HR-16146-54, N01 HR016146, N01 HR046058, N01 HR46058, T32HL007891)
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
acute lung injury, neuropsychological deficits, cognitive impairment, executive function, memory, verbal fluency, depression, post-traumatic stress disorder, anxiety, fluid management, conservative fluid management, hypoxemia, risk factors, ARDS survivors
MeSH terms
Adult, Anxiety Disorders, Cognition Disorders, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Prospective Studies, Respiratory Distress Syndrome, Stress Disorders, Post-Traumatic, Time Factors, Incidence, Multivariate Analysis, Logistic Models, Critical Illness, Survivors, Risk Assessment, Acute Lung Injury

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