Q: In post-intensive care syndrome (PICS), which one is the higher predictor of post ICU cognitive dysfunction? (select one)
A) degree and duration of delirium
B) degree and duration of sedating medications
Although an answer may be easy to guess, the objective of this question is to enhance three aspects of ICU care. One is to put emphasis on PICS, still an under-recognized condition. Second, long term effects of delirium in ICU, and third most important point to emphasize, is to put a little break on the notion of avoiding all sedation in ICU! Being an intensivist is more of an art than science. An ICU physician, being a healer needs to draw a fine line between patient's comfort and oversedation. Many times sedation is required to avoid not only short term but long term sequelae of critical care illnesses.
Pandharipande PP, Girard TD, Jackson JC, et al. Long-term cognitive impairment after critical illness. N Engl J Med 2013; 369:1306.