1. Registering for the Forum

    We require a human profile pic upon registration on this forum.

    After registration is submitted, you will receive a confirmation email, which should contain a link to confirm your intent to register for the forum. At this point, you will not yet be registered on the forum.

    Our Support staff will manually approve your account within 24 hours, and you will get a notification. This is to prevent the many spam account signups which we receive on a daily basis.

    If you have any problems completing this registration, please email support@jackkruse.com and we will assist you.

Want to see how current my info is? 10/2/2013 WSJ article

Discussion in 'The EMF Rx' started by Jack Kruse, Oct 3, 2013.

  1. Jack Kruse

    Jack Kruse Administrator

    Critically ill patients who survive a stay in an intensive-care unit, where they are often heavily sedated and ventilated, can find themselves mentally impaired long after release. A new study says the problem is far more common and lasting than previously believed.

    Nearly 80% of patients with prolonged ICU stays showed cognitive problems a year or more later, and more than half exhibited effects similar to Alzheimer's disease and traumatic brain injury, according to a report Wednesday in the New England Journal of Medicine.

    The researchers, at Vanderbilt University in Nashville, Tenn., and the Tennessee Valley Veterans Affairs Geriatric Research Education and Clinical Center, said the findings highlight the need to modify ICU practices that put patients at risk of cognitive problems, and to offer rehabilitation programs to restore concentration, thinking and memory function after patients leave the hospital.

    Enlarge Image

    Jason Andrew for The Wall Street Journal
    Joan Healy said that after a stay in an ICU, she suffered 'brownouts' during conversations, when she couldn't fully grasp what was being said.

    Intensive-care units traditionally keep patients heavily sedated, immobilized and on mechanical ventilation to keep them free of pain, anxiety and agitation as they heal or undergo invasive procedures. But prolonged sedation can trigger or exacerbate delirium, a temporary state of acute brain injury that can also be caused by conditions such as septic shock, an infection that spreads through the body and is a common reason for being admitted to an ICU.

    Delirium, long linked to higher rates of death, is also associated with long-term mental impairment in ICU survivors, the study found. E. Wesley Ely, senior author of the study and founder of Vanderbilt's ICU Delirium and Cognitive Impairment Study Group, said some ICU-related brain injury could be prevented if the duration of delirium in the ICU is shortened. A new protocol Vanderbilt and others are following includes weaning patients from sedatives carefully, waking them regularly to see if they can breathe on their own sooner, and getting them out of bed and moving as soon as possible.

    The study included 821 patients with respiratory failure or septic shock who had a median ICU stay of 5 days. Their ages ranged from 18 to 99. Only 6% had pre-existing cognitive impairment, and 75% developed delirium during their hospital stay. Assessed for cognitive function at one year after discharge, 34% still had scores similar to moderate traumatic brain injury, and 24% had scores similar to patients with mild Alzheimer's disease. In total, nearly 80% scored lower than predicted by age and education.

    "Whether you are young or old and even if you are previously healthy, if you go into an ICU with significant breathing problems, are on a breathing machine or in shock, you may not be coming out with an intact brain," said Dr. Ely. And after discharge, he adds, "so many people are living in their own private hell of mental fog and no one around them knows about it, tells them it is going to happen, or tries to prevent or treat it."

    Joan Healy, a 48-year-old who lives in Huntington, N.Y., spent a week in an ICU three years ago suffering from septic shock due to an infection. For two months after discharge, she said all she could do was sleep, and for the first year after recovery she would experience what she described as "brownouts," where she could do little more than nod and smile during conversations without grasping what was being said.

    Her family was just happy she was alive, making every effort to help, but "they can't fathom that I can't follow directions, that a simple recipe to cook for dinner is torture," Ms. Healy said. "It's like being in a dim room at sunset, you can navigate but you don't feel you have a grasp on everything going on around you."

    Ms. Healy, who does administrative work for her husband's orthopedics practice, reached out to experts at Vanderbilt, who referred her to a computer-based program for attention and memory problems, which she said has been helpful. "I am not the person I was, but from last year to now, I am doing better, and I am still working hard at it," she said.

    Malaz Boustani, chief operating officer of the Indiana University Center for Innovation and Implementation Science, who wasn't involved in the study, said its findings add to the evidence about brain-health concerns for ICU survivors and highlight the need for recovery programs that "coordinate the complex cognitive, functional and psychological recovery needs of Americans who survived a critical illness."

    Write to Laura Landro at laura.landro@wsj.com
  2. Jack Kruse

    Jack Kruse Administrator

    now go re read the EMF smoking gun for biology geeks link in the Sept 9, 2013 EE4 blog post............
  3. caroline

    caroline Moderator

    This explains so much to me.....my DH was in ICU for 14 days after heart bypass ......he never stood a chance......

Share This Page