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Am. J. Respir. Crit. Care Med., Volume 160, Number 1, July 1999, 50-56

Neuropsychological Sequelae and Impaired Health Status in Survivors of Severe Acute Respiratory Distress Syndrome

RAMONA O. HOPKINS, LINDELL K. WEAVER, DONNA POPE, JAMES F. ORME Jr., ERIN D. BIGLER, and VALERIE LARSON-LOHR

Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City; Division of Respiratory, Critical Care, and Occupational (Pulmonary) Medicine, University of Utah School of Medicine, Salt Lake City; and Department of Psychology, Brigham Young University, Provo, Utah

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.




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