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Systematic review of cognitive impairment and brain insult after mechanical ventilation

期刊

CRITICAL CARE
卷 25, 期 1, 页码 -

出版社

BMC
DOI: 10.1186/s13054-021-03521-9

关键词

Ventilators; Mechanical; Brain injuries; Delirium; Apoptosis; Cognitive impairment

资金

  1. Lungpacer Medical, Inc.
  2. Royal Columbian Hospital Foundation
  3. TB Vets
  4. MITACS

向作者/读者索取更多资源

Through a systematic review, it was found that mechanical ventilation may be associated with neuroinflammation, cognitive impairment, and brain insult, but no clinical studies have demonstrated a causal link between MV, cognitive dysfunction, and brain insult. More research should focus on ventilation-induced brain injury pathways and causative linkage.
We conducted a systematic review following the PRISMA protocol primarily to identify publications that assessed any links between mechanical ventilation (MV) and either cognitive impairment or brain insult, independent of underlying medical conditions. Secondary objectives were to identify possible gaps in the literature that can be used to inform future studies and move toward a better understanding of this complex problem. The preclinical literature suggests that MV is associated with neuroinflammation, cognitive impairment, and brain insult, reporting higher neuroinflammatory markers, greater evidence of brain injury markers, and lower cognitive scores in subjects that were ventilated longer, compared to those ventilated less, and to never-ventilated subjects. The clinical literature suggests an association between MV and delirium, and that delirium in mechanically ventilated patients may be associated with greater likelihood of long-term cognitive impairment; our systematic review found no clinical study that demonstrated a causal link between MV, cognitive dysfunction, and brain insult. More studies should be designed to investigate ventilation-induced brain injury pathways as well as any causative linkage between MV, cognitive impairment, and brain insult.

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