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Cognitive Rehabilitation Interventions in the Intensive Care Unit: A Systematic Integrative Review.

Kamila C Lassen1, Eva Laerkner2, Janet F Jensen3

  • 1Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Acta Anaesthesiologica Scandinavica
|April 24, 2026
PubMed
Summary

Early cognitive rehabilitation in the ICU may help attention and memory. However, more high-quality research is needed to confirm benefits for patients recovering from critical illness.

Keywords:
cognitive impairmentcritical illnessintensive carerehabilitationsystematic integrative review

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Area of Science:

  • Critical care medicine
  • Neuroscience
  • Rehabilitation therapy

Background:

  • Critical illness and intensive care unit (ICU) stays often impair cognitive functions like attention, memory, and executive function.
  • Early cognitive rehabilitation during ICU stays may mitigate these deficits, reduce delirium, and improve patient recovery.
  • This review identifies interventions and outcomes of cognitive rehabilitation initiated during critical illness.

Purpose of the Study:

  • To identify and describe cognitive rehabilitation interventions used during ICU stays.
  • To identify healthcare professionals delivering these interventions.
  • To summarize patient-important outcomes and assess study quality for future research.

Main Methods:

  • A systematic integrative review was conducted using multiple databases (Medline, EMBASE, CINAHL, CENTRAL).
  • Studies included adult ICU patients receiving or professionals delivering early cognitive rehabilitation in the ICU.
  • PRISMA guidelines were followed for data synthesis, with risk of bias assessed using RoB2 and ROBINS-I.

Main Results:

  • Twenty-seven studies were included, encompassing various designs (RCTs, cohort, qualitative, etc.).
  • Interventions included orientation, ADL-focused therapy, early mobilization, and technology-based stimulation, delivered by nurses, therapists, and family.
  • Multi-component programs showed potential cognitive benefits, but outcomes for delirium, ADL, ventilator-free days, quality of life, and survival were inconsistent and heterogeneous.

Conclusions:

  • Multi-component cognitive rehabilitation is clinically applicable in the ICU, but its impact on patient-important outcomes remains uncertain.
  • High-quality research is necessary to definitively evaluate the benefits of cognitive interventions for ICU patients.
  • Further investigation into the efficacy and cost-effectiveness of ICU-based cognitive rehabilitation is warranted.