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

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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, Hopkins, Ramona O., Angus, Derek C.·2012·American Journal of Respiratory and Critical Care Medicine

DOI 10.1164/rccm.201111-2025ocPMC PMC3381234

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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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Mikkelsen, 2008, Christie JD, for the ARDSNet. Conservative fluid strategy is associated with neurocognitive deficits in survivors of acute lung injury [abstract], Am J Respir Crit Care Med, 177, A819

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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.
ORCID: Mikkelsen, Mark E.
Christie, Jason D.
Lanken, Paul N.
Thompson, B. Taylor
Bellamy, Scarlett L.
Localio, A. Russell
Angus, Derek C.
Venue: American Journal of Respiratory and Critical Care Medicine
Publisher: Oxford University Press (OUP)
Published: 2012-06
Volume: 185
Issue: 12
Pages: 1307-1315
ISSN: 1073-449X (ISSN-L)
1535-4970
DOI: 10.1164/rccm.201111-2025oc
PMC: PMC3381234
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: green
europepmc.org
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
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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The Adult Respiratory Distress Syndrome Cognitive Outcomes Study: Long-Term Neuropsychological Function in Survivors of Acute Lung Injury

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