ArticleAnnals of intensive care2017
Early impairment of intracranial conduction time predicts mortality in deeply sedated critically ill patients: a prospective observational pilot study.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: a systematic review.Critical care (London, England) · 2018Pooled it
- Prognostic value of brainstem auditory evoked potentials (BAEPs) and middle latency auditory evoked potentials (MLAEPs) in unconscious patients after cardiac arrest.Critical care (London, England) · 2025Article
- Altered lower brainstem neurophysiological response is associated with mortality in deeply sedated critically ill patients.Intensive care medicine · 2025Observational
- Study on the predictive value of early microcirculation perfusion indicators combined with neuroelectrophysiological monitoring for the occurrence and prognosis of sepsis-associated encephalopathy in neurocritical care patients.Frontiers in neurology · 2025Article
- Renal replacement therapy initiation strategies in comatose patients with severe acute kidney injury: a secondary analysis of a multicenter randomized controlled trial.Intensive care medicine · 2024Article
- The spectrum of sepsis-associated encephalopathy: a clinical perspective.Critical care (London, England) · 2023Review
- Neuro-Inflammatory Response and Brain-Peripheral Crosstalk in Sepsis and Stroke.Frontiers in immunology · 2022Review
- Neuroimmune Regulation in Sepsis-Associated Encephalopathy: The Interaction Between the Brain and Peripheral Immunity.Frontiers in neurology · 2022Review
- Article
- Septic-Associated Encephalopathy: a Comprehensive Review.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Brainstem dysfunction in critically ill patients.Critical care (London, England) · 2020Review
- Early abolition of cough reflex predicts mortality in deeply sedated brain-injured patients.PeerJ · 2020Article
- Vasopressor Therapy and the Brain: Dark Side of the Moon.Frontiers in medicine · 2019Review
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Authors and funding
16 authors.
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Abstract
backgroundSomatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected. In this prospective observational bi-center pilot study, we investigated whether early impairment of SSEP's ICCT and/or BAEP's IPCT could predict in-ICU mortality or altered mental status (AMS), in deeply sedated critically ill patients.
methodsSSEP by stimulation of the median nerve and BAEP were assessed in critically ill patients receiving deep sedation on day 3 following ICU admission. Deep sedation was defined by a Richmond Assessment sedation Scale (RASS) <-3. Mean left- and right-side ICCT and IPCT were measured for each patient. Primary and secondary outcomes were, respectively, in-ICU mortality and AMS defined as the occurrence of delirium and/or delayed awakening after discontinuation of sedation.
resultsEighty-six patients were studied of which 49 (57%) were non-brain-injured and 37 (43%) were brain-injured. Impaired ICCT was a predictor of in-ICU mortality after adjustment on the global Sequential Organ Failure Assessment score (SOFA) [OR (95% CI) = 2.69 (1.05-6.85); p = 0.039] and on the non-neurological SOFA components [2.67 (1.05-6.81); p = 0.040]. IPCT was more frequently delayed in the subgroup of patients who developed post-sedation AMS (24%) compared those without AMS (0%). However, this difference did not reach statistical significance (p = 0.053). Impairment rates of ICCT and IPCT were not found to be significantly different between non-brain- and brain-injured subgroups of patients.
conclusionIn critically ill patients receiving deep sedation, early ICCT impairment was associated with mortality. Somatosensory and brainstem auditory evoked potentials may be useful early warning indicators of brain dysfunction as well as prognostic markers in deeply sedated critically ill patients.
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