Fatores associados à ocorrência de alterações cognitivas em pessoas que sobrevivem a doenças críticas

Abstract

Introduction: Intensive Care Units (ICUs) are specialized units designed for the care of critically ill patients, aimed at monitoring patients who require complex care. However, the intensification of these treatments, combined with factors such as prolonged mechanical ventilation, the administration of vasopressors, analgesics, sedatives, muscle relaxants, and the occurrence of delirium, can negatively affect the patients' cognitive function. Additionally, literature indicates that prolonged hospitalization is an additional risk factor for the development of cognitive deficits, even after hospital discharge. In this context, there is a highlighted need for early and continuous cognitive assessment from the moment of ICU admission until discharge, using standardized tools capable of measuring cognitive changes throughout hospitalization. This would allow for proper management within the unit to mitigate cognitive impacts, as well as provide support for care after discharge from the unit. Objective: This study aimed to analyze the factors associated with the occurrence of cognitive changes in survivors of critical illnesses. Method: A prospective cohort study was conducted in an ICU of a University Hospital in Salvador, Bahia. The assessments were carried out using the Verbal Fluency Test and the Brief Portable Questionnaire on Mental State upon discharge. Results: Twenty participants took part in the study, with 20% of the participants showing some degree of cognitive alteration at the end of their hospitalization. The majority were male, with an average age of 60 years, an average of 5 days of ICU stay, and the majority self-identified as Black or Mixed-race. A multifactorial pattern of cognitive alteration was observed, with changes in language, memory, and temporal orientation during the discharge assessments. Conclusion: Cognitive changes were observed in patients who survived critical illnesses. The data found in this study align with what is reported in the literature, indicating the need for evaluations and assistance regarding cognitive aspects. The study emphasizes the importance of implementing cognitive assessments in ICUs to identify potential deficits early and plan appropriate interventions for cognitive rehabilitation post-hospital discharge. However, the associated factors should be further investigated in larger populations for more comprehensive conclusions.