Neurological Complications in Intensive Care Units: From Delirium to Long-Term Cognitive Dysfunction-A Narrative...

Area of Science:

• Critical care medicine
• Neuroscience
• Public health

Background:

• Intensive care medicine advances improve survival but increase neurological complications.
• Neurological issues range from acute brain dysfunction (delirium, coma) to long-term cognitive impairment (PICS).
• Delirium affects one-third of ICU patients, linked to higher mortality and prolonged hospitalization.

Purpose of the Study:

• Synthesize current knowledge on neurological complications in adult ICU patients.
• Focus on the continuum from acute brain dysfunction to long-term cognitive impairment.
• Highlight evidence-based, non-pharmacological strategies for prevention and management.

Main Methods:

• Narrative literature review.
• Focused on epidemiology, pathophysiology, risk factors, diagnosis, and prevention.
• Included studies on delirium, ICU-acquired cognitive impairment, PICS, and interventions.

Main Results:

• ICU neurological complications are multifactorial, involving patient vulnerability, illness severity, inflammation, sedation, and environment.
• Delirium is the most common acute brain dysfunction, strongly predicting adverse outcomes.
• Structured screening, early mobilization, sleep optimization, and care bundles reduce delirium.

Conclusions:

• Neurological complications are integral to critical illness, extending beyond ICU discharge.
• Early identification, prevention, and integrated care improve survival and cognitive outcomes.
• Future research should explore personalized neuroprotective strategies.