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Systematic review of cognitive impairment and brain insult after mechanical ventilation
We conducted a systematic review following the PRISMA protocol primarily to identify publications that assessed any links between mechanical ventilation (MV) and either cognitive impairment or brain insult, independent of underlying medical conditions. Secondary objectives were to identify possible...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945325/ https://www.ncbi.nlm.nih.gov/pubmed/33691752 http://dx.doi.org/10.1186/s13054-021-03521-9 |
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author | Bassi, Thiago G. Rohrs, Elizabeth C. Reynolds, Steven C. |
author_facet | Bassi, Thiago G. Rohrs, Elizabeth C. Reynolds, Steven C. |
author_sort | Bassi, Thiago G. |
collection | PubMed |
description | We conducted a systematic review following the PRISMA protocol primarily to identify publications that assessed any links between mechanical ventilation (MV) and either cognitive impairment or brain insult, independent of underlying medical conditions. Secondary objectives were to identify possible gaps in the literature that can be used to inform future studies and move toward a better understanding of this complex problem. The preclinical literature suggests that MV is associated with neuroinflammation, cognitive impairment, and brain insult, reporting higher neuroinflammatory markers, greater evidence of brain injury markers, and lower cognitive scores in subjects that were ventilated longer, compared to those ventilated less, and to never-ventilated subjects. The clinical literature suggests an association between MV and delirium, and that delirium in mechanically ventilated patients may be associated with greater likelihood of long-term cognitive impairment; our systematic review found no clinical study that demonstrated a causal link between MV, cognitive dysfunction, and brain insult. More studies should be designed to investigate ventilation-induced brain injury pathways as well as any causative linkage between MV, cognitive impairment, and brain insult. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03521-9. |
format | Online Article Text |
id | pubmed-7945325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79453252021-03-10 Systematic review of cognitive impairment and brain insult after mechanical ventilation Bassi, Thiago G. Rohrs, Elizabeth C. Reynolds, Steven C. Crit Care Review We conducted a systematic review following the PRISMA protocol primarily to identify publications that assessed any links between mechanical ventilation (MV) and either cognitive impairment or brain insult, independent of underlying medical conditions. Secondary objectives were to identify possible gaps in the literature that can be used to inform future studies and move toward a better understanding of this complex problem. The preclinical literature suggests that MV is associated with neuroinflammation, cognitive impairment, and brain insult, reporting higher neuroinflammatory markers, greater evidence of brain injury markers, and lower cognitive scores in subjects that were ventilated longer, compared to those ventilated less, and to never-ventilated subjects. The clinical literature suggests an association between MV and delirium, and that delirium in mechanically ventilated patients may be associated with greater likelihood of long-term cognitive impairment; our systematic review found no clinical study that demonstrated a causal link between MV, cognitive dysfunction, and brain insult. More studies should be designed to investigate ventilation-induced brain injury pathways as well as any causative linkage between MV, cognitive impairment, and brain insult. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-021-03521-9. BioMed Central 2021-03-10 /pmc/articles/PMC7945325/ /pubmed/33691752 http://dx.doi.org/10.1186/s13054-021-03521-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Review Bassi, Thiago G. Rohrs, Elizabeth C. Reynolds, Steven C. Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title | Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title_full | Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title_fullStr | Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title_full_unstemmed | Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title_short | Systematic review of cognitive impairment and brain insult after mechanical ventilation |
title_sort | systematic review of cognitive impairment and brain insult after mechanical ventilation |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945325/ https://www.ncbi.nlm.nih.gov/pubmed/33691752 http://dx.doi.org/10.1186/s13054-021-03521-9 |
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