Neuropsychological sequelae and impaired health status in survivors of severe acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is a disease of acute respirator y failure manifested by severe hypoxemia with a high mortality rate. Previo us outcome studies of ARDS have assessed survival and/or pulmonary function as the primary outcome variables. Cognitive or psychological outcomes foll owing ARDS have not been described, despite the possibility that ARDS patie nts are at risk for brain injury through hypoxemia or other mechanisms. In the current study 55 consecutive ARDS survivors completed a battery of neur opsychological tests and questionnaires regarding health status, cognitive and psychological outcomes at the time of hospital discharge and 1 yr after onset of ARDS. At hospital discharge, 100% (55 of 55) of survivors exhibit ed cognitive and affective impairments, as well as problems with health sta tus which affected their quality of life. At 1 yr after ARDS, 17 of 55 (30% ) patients still exhibited generalized cognitive decline. Forty-three of 55 (78%) patients had all or at least one of the following: impaired memory, attention, concentration and/or decreased mental processing speed. One year after ARDS a substantial portion of ARDS survivors exhibit impaired health status and cognitive sequelae which may be due to hypoxemia, emboli, infla mmation, drug toxicity, and/or other etiologies.