He adds that too often providers consider themselves "successful if we get our patients out of our hospitals alive. But perhaps we need to think harder about getting them back to the quality of life they had prior to their hospitalization. That would be a better barometer of success."
Hinging on earlier work by his team, Pandharipande also is looking for how the neurochemical process that causes delirium may be damaging regions of the brain affecting cognition. That work is still in progress, he says.
In an accompanying editorial, Margaret Herridge, MD and Jill Cameron, of the Division of Critical Care and Division of Pulmonary and Critical Care at the University Health Network in Toronto, say the Vanderbilt study "unequivocally" shows that neurocognitive dysfunction is a common event after critical illness.
And, they wrote, the researchers "underscore that surveillance and intervention for delirium remain crucial to best ICU practice, as does an ICU culture of wakefulness and mobility."
The study "should fuel an informed discussion about what it means for our patients to survive an episode of critical illness, how it changes families forever, and when the degree of suffering and futility becomes unacceptable from a patient-centered and societal standpoint," they wrote.