Cortical arousal in critically ill patients: an evoked response study

Rundshagen, I.; Schnabel, Kai; Pothmann, W.; Schleich, B.; Esch, Jochen Schulte am

doi:10.1007/s001340000591

Cited by 15 publications

(6 citation statements)

References 15 publications

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“…An interesting question for further research is the attempt to objectify the experience of wakefulness by measuring sedation with clinical scoring systems or electrophysiological monitoring [28,29]. This might help regarding future therapeutic options.…”

Section: Discussionmentioning

confidence: 99%

Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care

et al. 2001

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Critically ill patients reported a high incidence of recall for unpleasant events, which they thought to have taken place before they regained consciousness. The patients, who stayed longer than 24 h at the ICU, indicated vivid memory for nightmares and hallucinations. Further studies are suggested to evaluate: 1) whether there is an impact of the present findings on outcome; and 2) whether clinical scores for sedation or neurophysiological monitoring help to define the exact time, when recall happens, in order to guide therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care

et al. 2001

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“…Other studies have evaluated the response of BIS and MLAEP to different stimuli in critically ill patients. Changes in MLAEP in critically ill adults after physiotherapy and tracheal suction were analysed in two studies [13,14]. A significant reduction in the latency of the negative wave Nb was observed in both studies after the stimuli, indicating a decrease in the level of sedation.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are very few studies that have performed this evaluation in critically ill adults [13][14][15], and only one that has studied the use of BIS and the COMFORT scale following tracheal suctioning in critically ill children [16].…”

mentioning

confidence: 99%

Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children

et al. 2008

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SummaryWe performed simultaneous recordings of Bispectral Index (BIS) and middle latency auditory evoked potentials. We also recorded two clinical scales, the Modified Ramsay scale and the COMFORT scale. Heart rate and blood pressure were measured once a day, for a maximum of 5 days, in 81 critically ill children. Changes with tactile, auditory, and painful stimuli were analysed. All the stimuli significantly increased the BIS value, the painful stimulus having the greatest effect. The painful stimulus was the only one that altered the middle latency auditory evoked potentials. Although the responses of the clinical scales to stimuli were statistically significant, they were of little clinical relevance. None of the stimuli used significantly altered the heart rate or blood pressure. We conclude that tactile, auditory and painful stimuli produced changes of little relevance in the clinical scales, BIS or middle latency auditory evoked potentials. We found the BIS was the most sensitive method and the painful stimulus had the greatest effect.

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“…There is some initial data using auditory and median nerve somatosensory evoked responses (MnSSER) suggesting that changes in these waves indicate cortical arousal in ICU patients. 13 …”

Section: Sedation and Neuromuscular Blockadementioning

confidence: 99%

The Year in Review: Critical Care Medicine

Rudis

Hoang

2001

Journal of Pharmacy Practice

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Background: There have been significant recent advances in the pharmacotherapeutic management of critically ill patients. The purpose of this article is to review and discuss the most pertinent published literature in the areas of neurology, cardiovascular diseases, infectious diseases, nephrology, hematology, and gastroenterology as it pertains to critical care in order to provide an update for the critical care practitioner.Methods: We performed a Medline search from July 1999 to December 2000 utilizing terms relating to the pharmacotherapy of the specific aforementioned topics in critical care medicine. We focused on English-language clinical studies performed in adult intensive care unit (ICU) patients. From these articles we selected those that would have a practical impact on drug therapy in the ICU or the development of drug usage guidelines for critically ill patients. Review articles were generally not included.Results: The following topics were found to be either new developments or of potentially significant impact in the management of adult critically ill patients. In the area of neurology, advances were found with respect to optimization of regimens for sedative and neuromuscular blocking agents, validation of sedation scales and tools, and in the treatment of head injury patients. In the cardiovascular diseases, most studies related to the hemodynamic support of septic shock. We focus on developments in fluid resuscitation, optimization of global and regional oxygen transport variables, the repositioning of vasopressor agents, and a return to the use of steroids. Given the high mortality rate associated with the development of acute renal failure in the ICU, there has been a consistent attempt to develop preventative and treatment strategies for these patients, including optimization of antimicrobial dosing methods. Several epidemiological and longitudinal studies document changes in multi-drug antimicrobial resistance patterns. The use of treatment guidelines for antimicrobials in the critically ill improves outcomes in most patients. Significant attention has focused on the characterization of anemia in the ICU and the development of alternative pharmacological strategies in its treatment. Finally, in gastroenterology, the main focus has been the investigation of methods to optimize the delivery of enteral nutrition given its proven benefits in critically ill patients.Conclusions: Significant advances in the areas of neurological, cardiovascular, infectious diseases, renal, hematological, and gastrointestinal issues in the pharmacotherapy of critically ill patients have been published over the course of the past year. Many of these studies have yielded data that may be incorporated into the pharmacotherapeutic management of ICU patients, hence maximizing outcomes.

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Cortical arousal in critically ill patients: an evoked response study

Cited by 15 publications

References 15 publications

Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care

Incidence of recall, nightmares, and hallucinations during analgosedation in intensive care

Responsiveness to stimuli of bispectral index, middle latency auditory evoked potentials and clinical scales in critically ill children

The Year in Review: Critical Care Medicine

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