Systematic review of cognitive impairment and brain insult after mechanical ventilation

Area of Science:

• Neuroscience
• Critical Care Medicine
• Neurology

Background:

• Mechanical ventilation (MV) is a critical intervention in intensive care.
• Potential neurological side effects of MV, including cognitive impairment and brain insult, require thorough investigation.
• Understanding the relationship between MV and brain health is crucial for patient outcomes.

Purpose of the Study:

• To systematically review existing literature on the association between mechanical ventilation and cognitive impairment or brain insult.
• To identify gaps in current research to guide future studies.
• To explore potential pathways linking MV to neurological damage.

Main Methods:

• Systematic literature review adhering to the PRISMA protocol.
• Inclusion of preclinical and clinical studies assessing MV's impact on cognitive function and brain injury.
• Analysis of neuroinflammatory markers, brain injury indicators, and cognitive scores.

Main Results:

• Preclinical studies suggest MV is linked to neuroinflammation, cognitive impairment, and brain injury, with longer ventilation correlating with worse outcomes.
• Clinical literature indicates an association between MV, delirium, and potential long-term cognitive impairment.
• No clinical studies definitively established a causal link between MV, cognitive dysfunction, and brain insult.

Conclusions:

• While preclinical data suggest harm, clinical evidence for a direct causal relationship between MV and brain injury remains insufficient.
• Further research is needed to elucidate ventilation-induced brain injury pathways.
• Future studies should focus on establishing a causative linkage between MV and cognitive impairment.