Blood glucose dysregulation and cognitive outcome in ARDS survivors

Objective: Hyperglycaemia is common in critically ill patients and may contribute to increased mortality and morbidity. This study assessed the impact of blood glucose on cognitive outcome in acute respiratory distress syndrome (ARDS) patients' 1 year post-hospital discharge. Design: Retrospective data for 74 ARDS survivors who were enrolled in a prospective mechanical ventilation randomized clinical trial. A standard protocol was used to manage blood glucose. The highest, lowest, mean and standard deviation glucose values were examined, as well as duration of hypoxemia and other clinical data. Standardized neuropsychological tests were administered to identify cognitive sequelae. Logistic regression models were used to assess risk factors for cognitive sequelae. Measurements and results: There was a significant relationship between the blood glucose and cognitive sequelae. Greater duration of mechanical ventilation and highest blood glucose predicted cognitive sequelae. Conclusions: Blood glucose dysregulation, specifically moderate hyperglycaemia and ICU length of stay, predicted adverse cognitive sequelae in ARDS patients.