Robotic technology provides objective and quantifiable metrics of neurocognitive functioning in survivors of critical illness:A feasibility study

Abstract

Purpose: To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS).

Materials and methods: Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot.

Results: At 3- and 12-months after ICU discharge, 28/70 (40%) and 22/70 (31%) returned for follow-up testing, respectively. Prominent reasons for declining testing at 3- and 12-months included: not interested (40% and 38%) and health complications (31% and 31%). The majority of returning participants completed all tasks (96%-100%) and 100% of available data was recorded. On the RBANS, 54% (3 months) and 32% (12 months) of individuals were impaired in visuospatial/constructional skills. Similarly, the KINARM assessments demonstrated that 56% of individuals had visuospatial/executive dysfunction at 3 months, and 40% had impairment at 12 months. Individual scores indicated substantial variability.

Conclusions: We demonstrated that it was feasible to quantify neurological dysfunction among participants that returned for follow-up testing. However, future investigations will need to implement multiple retention strategies.

Trial registration: This trial is registered on clinicaltrials.gov (Identifier: NCT02344043), retrospectively registered January 8, 2015.

Keywords: Critical illness; KINARM; PICS; Post-intensive care syndrome; RBANS.