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Neurocognitive Consequences of ALI
2 Minute EBP Challenge
Stay up-to-date the easy way!
How would you answer this question?
Conservative fluid management decreases long-term neuropsychological function in patients who recover from Acute Lung Injury, leading to what outcome:
a. 62% incidence of anxiety
b. 10% incidence of depression
c. 91% incidence of post-traumatic stress disorder
d. 25% incidence in memory impairment
The correct answer is "a" 62% incidence of anxiety.
View the video response on YouTube.
Acute Lung Injury (ALI) results in Adult Respiratory Distress Syndrome (ARDS) and can cause long-term physiological and psychological effects. Most physiological effects are due to the direct lung injury, but the mechanism of the psychological effects is unknown.
Dr. Mikkelsen, et al. (2012) studied patients who recovered from ALI and found long-term psychological and cognitive dysfunction being quit common: anxiety in 62%, cognitive impairment in 55%, depression in 36%, and post-traumatic stress disorder in 39%. The authors speculate that hypoxemia and conservative fluid resuscitation might contribute to poor neurocognitive outcomes -- both were significantly associated with poor outcomes.
Neurocognitive dysfunction is common after recovery from ALI. Give patients and families the resources they will need to cope with the psychological side efffects. More research is need to determine if changing practice during resuscitation will improve long-term neurological outcomes.
From: Mikkelsen, E., et al. (2012). The Adult Respiratory Distress Syndrome
Cognitive Outcomes Study: Long-term neuropsychological function in survivors of acute lung injury. American Journal of Respiratory and Critical Care Medicine, 185(12), 1307-1315.
Congratulations to Barbara Reap who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question correctly. Congratulations Barbara!
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David W. Woodruff, MSN, RN-BC, CNS, CMSRN, CEN
President, Ed4Nurses, Inc.
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