Critical Illness
Conditions
Keywords
Critical illness, Neurocognition, Neurocognitive stimulation, Delirium, Virtual Reality, cognitive, rehabilitation, ICU
Brief summary
The purpose of this project is to assess the efficacy of an early neurocognitive intervention for ICU patients, in terms of psychopathological, neuropsychological and functional improvement. The treatment is supported in an interactive advanced computing platform that includes the continuous biomedical registration of the patients and a virtual reality software specifically designed for critical patients. The investigators expect an improvement in neuropsychological, psychopathological and functional status at hospital discharge and 3 months follow-up in those patients that have received the early neurocognitive intervention comparing with patients treated as usual. Furthermore the investigators expect a decrease of episodes and/or duration of delirium in ICU patients.
Interventions
OTHERNeurocognitive stimulation
Sponsors
Fundació La Marató de TV3
Corporacion Parc Tauli
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged between 18 and 80 years * Patients receiving mechanical ventilation for at least 24 hours * Patients scoring more than 8 on the Glasgow Coma Scale (GCS) and more than 2 on the Sedation Agitation Scale (SAS) * Patients haemodynamically stable * Informed consent signed by the closest relatives.
Exclusion criteria
* Patients with previous neurologic pathology or focal brain injury before ICU admission * Patients with serious psychiatric pathology (major depression, psychosis, bipolar disease) or mentally retarded * Patients with sensorial alterations needed to interact with the neurocognitive stimulation programme * patients whose closest relatives refuse the subject to be included in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Executive Functions | Hospital discharge and 3-months after hospital discharge | * Stimuli alternation and sequencing: Trail Making Test A-B (Mimeo & Manga, 1999) * Automatic inhibition response: Stroop Test (Golden & Charles, 1978) * Visual planning: Tower of London (Shallice, 1982). * Phonetic verbal fluency: FAS test (Spreen and Benton, 1995) * Semantic verbal fluency: Animals 1' (Benton & Hamsher, 1976) |
| Attention | Hospital discharge and 3-months after hospital discharge | * Verbal attention: Digits Forward subtest of the WAIS III (Wechsler, 1999) * Visual attention: Spatial Localization Forward subtest of the WMS III (Wechsler, 1999) * Sustained/Selective attention: Continuous Performance Test (Conners, 1992) |
| Memory | Hospital discharge and 3-months after hospital disharge | * Verbal learning and memory: Auditory Verbal Learning Test (Rey, 1964) * Visual learning and memory: 10/36 Spatial Recall Test (Rao, 1992) * Visual recognition: Benton Visual Retention Test (Benton, 1983) |
| Functional Status | hospital discharge and 3-months after hospital discharge | * Quality of life questionnaire: Satisfaction and Pleasure (Q-LES-Q) (Endicott, J., Nee, J., Harrison, W. & Blumenthal, R., 1993) * Lawton and Brody Functional Scale (1969) |
| Speed processing | Hospital discharge and 3-months after hospital discharge | \- Information processing speed: Symbol Search subtest of the WAIS III (Wechsler, 1999) |
| Psychopathological status | Hospital discharge and 3-monts after hospital discharge | * Depression: Hamilton Depression Rating Scale (HDRS) (Hamilton, 1960) * Anxiety: Hamilton Anxiety Rating Scale (HAM-A) (Hamilton, 1959) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delirium | Every day during ICU stay | Number of episodes and duration of delirium: Confusional Assessment Method for Intensive Care Unit (CAM-ICU) |
Countries
Spain
Outcome results
None listed