Changes in cognitive function after pediatric intensive care unit rounds: a prospective study
-
Matthew L. Friedman
and
Mary E. McBride
Abstract
Background:
Mental fatigue is impaired cognitive function induced by engaging in cognitively demanding activities. Pediatric intensive care unit (PICU) rounds are demanding and may be a cause of impaired cognitive functioning. The purpose of this study is to evaluate if PICU rounds induce poorer performance on cognitive tasks after rounds compared to before rounds and assess the feasibility of cognitive testing in the PICU.
Methods:
This was a prospective study of residents in the PICU. Participants were evaluated before and after rounds on a single day, consisting of two tests of cognitive function that are sensitive to mental fatigue, the cognitive estimation test (CET) and the repeatable episodic memory test (REMT).
Results:
Thirty residents participated. The mean length of rounds was 191 min (SD 33.8 min), the mean number of patients rounded on by the team was 14.9 (SD 2.3) and the median patients presented by the participant was two (range 0–6). The average number of words recalled on the REMT was significantly lower after rounds compared to before (29.6 vs. 31.2, p < 0.05). There were significantly more falsely recalled words after rounds (1.3 vs. 0.7, p=0.02). There was a correlation between worsening performance and later time of testing in the 4-week PICU rotation (r=0.42, p < 0.02). There were no differences in performance on the CET.
Conclusions:
PICU rounds induced impairments on cognitive testing but the effect size is small and not consistent across tests. There is an increased susceptibility to impaired cognition induced by rounds over the course of a rotation, this finding merits further investigation.
Acknowledgments
We would like to thank all of the pediatric residents at Ann and Robert H. Lurie Children’s Hospital of Chicago who participated in this study. We would like to thank Dr. Z. Leah Harris, MD for her generosity of time and advice in the process of this study. We would like to thank Dr. Christine Park, MD for her guidance in the design of this study.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplemental Material:
The online version of this article (DOI: 10.1515/dx-2016-0018) offers supplementary material, available to authorized users.
©2016 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Point
- Why is diagnosis not probabilistic in clinical-pathological conference (CPCs): Point
- Counterpoint
- Diagnosis is driven by probabilistic reasoning: counter-point
- Original Articles
- Admissions after discharge from an emergency department for chest symptoms
- Inaccurate or delayed diagnosis of hollow organ perforation by emergency physicians: using a qualitative approach to identify the causes
- Changes in cognitive function after pediatric intensive care unit rounds: a prospective study
- Access to scientific information. A national survey of the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC)
