2024 Volume 36 Issue 1 Pages 36-41
Intensive care unit-acquired delirium can lead to persistent cognitive dysfunction. Although it impedes independent mobilization at hospital discharge, the effects in intensive rehabilitation in the recovery phase remain unclear. An 84-year-old male was admitted to our intensive care unit with dyspnea. He was diagnosed with influenza-related pneumonia and sepsis and was placed on a mechanical ventilator for complete respiratory support. On day 14 （D14） of illness, rehabilitation was initiated. On D33, reductions in physical and cognitive functions were observed through Medical Research Council and Mini-Mental Statement Examination scores of 34 and 11 points, respectively. During his intensive care unit stay, he showed signs of delirium for 27 consecutive days. On D47, he was admitted to a postacute rehabilitation hospital where he underwent physical （strength training; basic movement, balance, and gait exercises; and endurance training）, occupational （activities of daily living training）, and speech （cognitive training, primarily higher-order tasks） therapies for 90 min daily. On D115, his physical function was markedly improved （Medical Research Council score, 57 points）; however, his cognitive impairments persisted. On D124, he was transferred to a long-term care facility. Seamless rehabilitation from the acute to the convalescent phase was performed; however, the improvement in cognitive impairment following intensive care unit-acquired delirium was less than the improvement in physical function. Even after discharge from recovery hospitals, rehabilitation should be continued in addition to interventions in the intensive care unit aimed at preventing delirium and cognitive impairment and hastening recovery.
