Long-term outcome after acute lung injury.

PURPOSE OF REVIEW As incidence of acute lung injury (ALI) increases and case fatality decreases, long-term care of survivors is of public health importance. Previous studies demonstrate that these survivors are at risk for impairment in physical, cognitive and mental health. In this review, we will discuss recent studies that add to our knowledge of long-term outcomes after ALI and critical illness. RECENT FINDINGS New studies show that persisting impairment in physical and cognitive function continues 5 years after recovery from critical illness. Glucose dysregulation may play a role in development of both depression and cognitive impairment. Premorbid impairment appears to be an important risk factor, but critical illness is an independent risk factor of physical and cognitive functional decline. Recent randomized controlled trials emphasize that post-ICU interventions may not be enough to improve health-related quality of life after ALI. Interventions delivered early in critical illness, such as physical and occupational therapy and creation of ICU diaries, may be key in improving late outcomes after ALI. SUMMARY Physical, cognitive and mental health impairments after ALI are common, persistent and expensive. Future research is needed to improve prediction, prevention and treatment of these important sequelae.