隐藏的危急疾病脑病变:通过指导方针推,协议化评估来逃避检测的障碍
Ruhi Shirodkar1, Isaac J Bourgeois2, Minjee Kim1
1Department of Neurology, Northwestern University, Chicago, IL.
Critical care medicine
|December 24, 2024
概括
妄和脑病的标准查工具可能会忽略严重病患者的显著认知障碍. 许多患者表现出执行功能,处理速度和工作记忆的缺陷,尽管查结果正常.
科学领域:
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
- 心理学 心理学 心理学
背景情况:
- 痴呆症和脑病变在重症患者中很常见.
- 标准查仪器用于检测这些情况.
研究的目的:
- 为了确定指导方针推的查仪器是否无法检测危急病患者的重大认知障碍.
主要方法:
- 进行了一项横截面研究,在ICU中随机抽取患者样本.
- 在标准查 (CAM-ICU,RASS,GCS) 上评估了50名没有妄想症或脑病变的重症患者.
- 用NIH工具箱心理测量电池评估认知功能.
主要成果:
- 患者表现出执行功能 (注意力,抑制控制) 和处理速度 (1.5 SD低于正常) 的显著损害.
- 工作记忆和认知灵活性也受到损害.
- 64%的患者在两个或两个以上的认知领域有障碍.
结论:
- 标准的妄和脑病查工具可能无法在重症患者中发现实质性的认知障碍.
- 即使标准评估正常,认知缺陷也很普遍.
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