Cognitive changes after survival of critical illness

This is now a well known entity. It was recently reviewed here in CCJM. Strategies for prevention remain controversial. Much attention has been devoted to sedation during mechanical ventilation in terms of dose, duration and choice of agent. And while these factors may impact the development of delirium it is not clear whether they affect the development of impaired cognition weeks and months after recovery. Regarding the choice of ventilator sedation agent the authors opine:

In our practice, we use dexmedetomidine as our first-line sedation therapy. In patients with hemodynamic instability, we use benzodiazepines. We reserve propofol for very short periods of intubation or for hemodynamically stable patients who cannot be sedated with dexmedetomidine.