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Objective:To clarify the operational definition of ICU cognitive impairment, so as to provide a reference for accurate assessment of ICU cognitive impairment.Methods:ICU cognitive impairment was conceptually analyzed by the conceptual analysis framework in the Construction Strategy of Nursing Theory (Fifth Edition). The studies about cognitive function of critical illness patients in PubMed, Web of Science, Embase, China National Knowledge Internet, Wanfang, Chinese Biomedical Database, and VIP were searched. The search time limit was from the establishment of the database to August 2021. Literature screening and data extraction were performed independently by two researchers.Results:A total of 5 754 articles were obtained, and 48 articles were finally included. Obtained 20 concepts and 9 commonly used assessment tools related to ICU cognitive impairment. Identifying the defining attributes, conceptual causes, and outcomes of ICU cognitive impairment.Conclusions:The operational definition of ICU cognitive impairment is determined, which is conducive to a comprehensive and intuitive understanding of the concept of cognitive impairment in ICU and accurate evaluation of cognitive impairment in ICU.
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Post-intensive care syndrome (PICS) is the most common complication in patients discharged from intensive care unit (ICU), which seriously affects the life quality of the patients. At present, there is still lack of standardevaluation methods for PICS. Continuous and dynamic assessment can earlyidentify PICS, moreover, early identification and intervention of PICS can improve the life quality of patients those patients, which is critical to improve the long-term outcome of the patients. In this paper, we reviewed the current research states of evaluation timing, contents, tools and modalities of PICS domestic and abroad, analyzed the problems and prospects of the existing evaluation methods, aiming to provide a reference for clinical staff to effectively and comprehensively evaluate PICS.
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Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD) ,and explore the correlation between them.Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116).TABP,Social Support Scale, MMSE, NIHSS,mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80);fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls (NC group).Results (1) The incidence of acute PSD was 31.03％.(2)The constituent ratio of type A behavior(83.33％ vs 57.50％), CH scores, TH +CH scores were significantly higher in PSD group than NPSD group(P＜0.01).Social Support Scale scores,MMSE scores were significantly lower in PSD group than NPSD group(P＜0.01, P＜0.05).NIHSS scores,mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P＜0.01).(3) The levels of serum BDNF,hs-CRP in the PSD group,the NPSD group and the normal control group were respectively (BDNF (617.24(274.98,976.22)) pg/ml, (938.19(615.88,1 714.76)) pg/ml, (4 149.46(1 658.83,7 583.34)) pg/ml);(hs-CRP(6.47(2.66,11.21)) mg/L, 1.77(0.74,6.51) mg/L, (0.86(0.47,1.59)) mg/L).The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group (P＜0.01).(4) The severity of depression was positively correlated with CH,TH+CH scores(r=0.38, P＜0.05;r=0.43, P＜0.01).CH scores were negatively correlated with social support(r=-0.38, P＜0.05),and were positively correlated with hs-CRP levels(r=0.34, P＜0.05).Conclusion In patients with post stroke depression,the BDNF levels decrease and hs-CRP levels increase,but severity of depression and cognitive function are not correlated with BDNF levels.Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support.Hostility and excessive competition are psychosocial risk factors occurring PSD.