ArticleJournal of thoracic disease2017
Pupillary abnormalities in non-selected critically ill patients: an observational study.
Article in Journal of thoracic disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 14 citations in OpenAlex.
- Isolated reversible mydriasis was associated with the use of nebulized ipratropium bromide: a case series using quantitative pupilometer in Korea.Acute and critical care · 2024Article
- Feasibility study of a smartphone pupillometer and evaluation of its accuracy.Journal of clinical monitoring and computing · 2021Article
- Quantitative assessments of pupillary light reflexes in hospital-onset unresponsiveness.BMC neurology · 2021Observational
- Rare autonomic nervous system dysfunction: Alternating bilateral mydriasis.World journal of emergency medicine · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRepeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population.
methodsWe performed a prospective, observational study in a medical university affiliated ICU over a 6-month period. All patients with at least one pupillary examination were included. PA was defined as areflexia and/or anisocoria present at the time of ICU admission or occurring during the ICU stay.
resultsDuring the study period, we included 297 patients who had 6±9 pupillary examinations per day (totaling 11,360 pupillary assessments). The majority of patients (n=161, 54%) were admitted to the ICU for acute respiratory or cardiovascular failure. A total of 128 PAs were recorded in 109 patients: 78 areflexia alone (61%), 33 anisocoria alone (26%) and 17 (13%) with associated anisocoria and areflexia. The main causes of PAs were related to acute brain ischemia (n=41, 32%) and sedation/analgesia (n=50, 39%). Among the PAs, 59 (46%) were present upon ICU admission. The etiologies of the PAs at admission did not differ from those occurring during ICU stay (P=NS). Interestingly, 9 (7%) PAs were attributed to ipratropium nebulization in patients with chronic obstructive pulmonary disease exacerbation.
conclusionsThe high prevalence of PAs, frequently associated with both brain organic lesions and drug side effects, highlights the clinical interest of pupillary surveillance in non-selected critically ill patients.
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