Author/Authors :
Porhomayon, Jahan State University of New York at Buffalo - School of Medicine and Biomedical Sciences - Department of Anesthesiology, Division of Critical Care Medicine, VA Western New York Healthcare System, USA , Joude, Philippe State University of New York at Buffalo - School of Medicine and Biomedical Sciences - Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, VA Western New York Healthcare System, USA , Adlparvar, Ghazaleh State University of New York at Buffalo - Monroe College, School of Medicine and Biomedical Sciences, USA , El-Solh, Ali A. State University of New York at Buffalo - School of Medicine and Biomedical Sciences - Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, VA Western New York Healthcare System, USA , Nader, Nader D. State University of New York at Buffalo - School of Medicine and Biomedical Sciences - Department of Anesthesiology, Division of Cardiothoracic Anesthesia and Pain Medicine, VA Western New York Healthcare System, USA
Abstract :
Background: The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU). We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. Methods: We performed a systemic search and meta-analysis of medical databases in MEDLINE(from 1966 to March 2013) and EMBASE (from 1980 to March 2013), as well as the Cochrane Library using the MESH terms Intensive Care Unit, and Mental Health, for assessing the impact of sedation on posttraumatic stress disorder (PTSD) or anxiety/depression and deliriumin the mix ICU setting including cardiac surgery patients. A total of 1216 patients were includedin the final analysis. Results: We included 11 studies in the final analysis and concluded that high dose sedationstrategy resulted in higher incidence of cognitive dysfunction with P value of 0.009. Theresult for subgroup of delirium showed P = 0.11 and PTSD/depression or anxiety of P = 0.001,Heterogeneity I2 was 64%. Overall analysis was statistically significant with a P value of 0.002. Conclusion: High sedation dosing strategy will negatively affect cognitive function in criticallyill patients. Large randomized trials are needed to address cognitive dysfunction in subgroup of patients with delirium.
Keywords :
Posttraumatic Stress Disorder , Depression , Cognitive Function , Sedation , Delirium , Cognitive Function
