Stay in Intensive-Care Units may Lead to Long-Lasting Brain Problems

Medical malpractice lawyers at Pintas & Mullins Law Firm report on a recent study which found that patients are suffering long-term brain risks after being admitted to intensive-care units throughout the U.S. In fact, nearly 80% of patients who survived prolonged ICU stays showed cognitive issues one year or more after being discharged.

The study was conducted at Vanderbilt University and the Tennessee Valley Veterans Affairs Geriatric Research Education Center, and published recently in the New England Journal of Medicine. In addition to the 80% of patients reporting cognitive issues, more than half of all ICU patients exhibited brain effects similar to Alzheimer’s and traumatic brain injury.

Patients admitted to the ICU are critically ill, often heavily sedated and ventilated, and immobilized to relieve them of pain, anxiety and agitation. Long periods of sedation, however, have far-reaching effects that are still not fully understood. Current ICU practices can trigger or make worse preexisting delirium, a type of acute brain injury that can be caused by reasons the patient was in the ICU to begin with, creating a vicious and extremely damaging cycle of brain injury.

Specifically, delirium is linked to septic shock (also known as sepsis), a blood infection that quickly spreads through the body from inflammation. It can cause destruction to multiple organ system, causing them to fail, and is most common and extremely fatal in the elderly, particularly those in understaffed or mismanaged nursing homes.

Patients in the ICU are particularly susceptible to developing infections which may lead to sepsis, and, unfortunately, the incidence of sepsis appears to be increasing in U.S. hospitals. The Mayo Clinic lists the possible reasons for this as: an aging population (Americans are living longer overall), weakened immune systems (from cancer, HIV, infections), drug-resistant bacteria, and medical advances, as patients are undergoing more complicated medical treatments.

Additionally, the mortality rate from septic shock is nearly 50%, and an episode may place patients at higher risk for future infections. The study also found that delirium is associated with long-term mental impairment. The lead-author stated that physicians could significantly curtail ICU-related brain injury if the length of time patients spend in delirium is shortened. This can be achieved by weaning patients off sedatives and allowing them to awaken, checking to see if they can breathe on their own much sooner, and getting them out of bed and moving around more rapidly.

The study examined over 820 patients with a median ICU stay of five days. All patients either suffered respiratory failure or septic shock, and ranged in age from 18 to 99. Just over 5% had preexisting cognitive impairment, and a staggering 75% developed delirium while in the ICU. Perhaps most troublingly, when they were assessed one year after being discharged, 34% reported minor to moderate traumatic brain injury, and 24% scored similarly to Alzheimer’s patients in cognitive tests.

Even more tellingly, just about 80% of patients evaluated after their ICU stay scored lower than predicted by age and education on the cognitive tests. What’s worse, physicians and hospital staff never inform ICU patients of this risk, that their brains may not be intact, or try to prevent or treat the brain issues.

One patient, 48-year-old Joan Healy, spent one week in an ICU about three years ago. She developed septic shock but was able to survive it. After she was discharged, she slept for two months at home; for the first year after, in conversations with friends she would experience “brown-outs,” or periods of time where she could not grasp what was being said. She still cannot properly follow directions – just reading a recipe to cook dinner is torture for her.

Medical malpractice attorneys at Pintas & Mullins Law Firm highlight this article to reinforce the need to modify ICU practices. The current system is defective, and places patients at an exceedingly high – and unnecessary – risk of long-lasting cognitive problems. ICUs throughout the country need to refocus on rehabilitation programs to improve cognitive functions. If you or a loved one was seriously injured or killed by inadequate or negligent hospital care, contact one of our skilled malpractice attorneys who can inform you of your rights and legal options, free of charge.

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