Study: Brain injuries hiding in ICU patients

Brain injuries may be prevalent among patients exiting intensive care units (ICU), even if they entered the hospital for non-brain-related injuries or ailments, according to a new study by Western University and Lawson Health Research Institute.

The “astonishing” findings are a signal to medical professionals to be on alert for some level of undetected cognitive dysfunction that could hamper recovery in all ICU patients.

The findings were published today in the scientific journal, PLOS One.

For the study, researchers assessed 20 patients as they left the ICU. Despite the appearance of no clear brain injury, every single patient had detectible deficits in two or more cognitive areas, including memory, attention, decision-making and reasoning.

“Many people spend time in an intensive-care unit following a brain injury and, of course, they often experience deficits,” Western neuroscientist Adrian Owen explained. “In this study, we were interested to see how patients without a specific brain injury fair after leaving the ICU.

“The results were astonishing.”

Cognitive ability declines in non-brain related visits to the ICU likely vary from patient to patient. But Schulich School of Medicine & Dentistry professor Dr. Kimia Honarmand says many conditions affect brain function, even though they might not directly involve the brain.

“If you are having trouble breathing, your brain may be starved of oxygen. If you have a serious infection, the inflammation that occurs as a result of infection may affect brain function. If you are undergoing major surgery, you might be given drugs and have procedures that may affect your breathing, which in turn may affect the flow of oxygen to the brain,” Honarmand said.

“What we have shown here is that all or any of these events can lead to deficits in brain function that manifest as impairments in cognition – and healthy cognition is a vital determinant of functional recovery.”

Schulich professor Dr. Marat Slessarev said these findings can shift how the medical community treats incoming patients and more importantly, outpatients following ICU visits.

“Historically, the clinical focus has been on survival. Now, we can begin to focus on good survival,” Slessarev said. “These sensitive tests will enable doctors to both detect cognitive impairment and track cognitive performance over time – the first step in developing processes for optimizing brain recovery.”