Non-pharmacological interventions to support the cognitive rehabilitation of patients admitted to the intensive care unit: An umbrella review.
Anna Holm, Linette Thorn, Anette Bjerregaard Alrø and 3 others
PMID 39503063WHAT IT FOUND
No definitive conclusion can be drawn about non-pharmacological cognitive rehabilitation for ICU patients.
Interventions are described as personalized and multicomponent, but evidence is too limited to show which ones work.
Key findings
01The review found that the effectiveness of non-pharmacological interventions for ICU cognitive rehabilitation was very uncertain.
02No included research synthesis compared single interventions with multicomponent interventions, so it is unclear whether any observed impact was due to the multicomponent design or simply receiving an intervention.
03Former ICU patients described information from health care professionals as supportive during recovery from cognitive impairment, but their cognitive problems made it difficult to understand, recall, or process that information.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
This is a review of reviews, so intervention details may be too shallow to replicate. The authors included research syntheses other than systematic reviews and meta-analyses, which may lower the level of evidence. Many syntheses were excluded because cognitive outcomes were mixed with other post-intensive care syndrome outcomes. Studies on delirium prevention and COVID-19 cognitive rehabilitation were excluded, so useful interventions may be missing. The RETURN and ACT-ICU studies were cited most often, so their results may have shaped the review more than other studies. The search did not include grey literature. The analysis was qualitative and descriptive, with no quantitative synthesis of effect.
Declared interests
Funding was provided by the Novo Nordisk Foundation. The authors declared no conflict of interest.
The easy way to misread this
Do not read the review as showing that multicomponent cognitive rehabilitation works. The included reviews did not compare multicomponent interventions with single interventions, and the overall effectiveness was very uncertain.