Bench-to-bedside review: Brain dysfunction in critically ill patients - the intensive care unit and beyond

摘要: Critical care physicians often find themselves prognosticating for their patients, attempting to predict patient survival as well disability. In the case of neurologic injury, this can be especially difficult. A frequent cause coma in intensive unit is resuscitation following cardiac arrest, which mortality and severe disability remain high. Recent studies clinical examination, serum markers such neuron-specific enolase, somatosensory evoked potentials allow accurate specific prediction comatose patients are likely suffer a poor outcome. Using these tools, practitioners confidently educate family majority who will die or at 1 month. Delirium less dramatic form injury but, when sought, strikingly prevalent. addition, delirium associated with increased poorer functional recovery, prompting investigation into preventative therapeutic strategies counter delirium. Finally, damage may persist long after patient's recovery from critical illness, cognitive dysfunction detected months years illness. Psychiatric impairment including depression post-traumatic stress disorder also arise. Mechanisms contributing each entities reviewed.