To wake-up, or not to wake-up: that is the Hamletic neurocritical care question!
The need for a reliable neurological evaluation in severely brain-injured patients conflicts with sedation, which is routinely administered. Helbok and colleagues prospectively evaluated in a small cohort of 20 sedated severely brain-injured patients the effects of a wakeup test on intracranial pres...
| Main Authors: | , |
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| Format: | Journal article |
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BioMed Central
2012
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| _version_ | 1797090643255754752 |
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| author | Prisco, L Citerio, G |
| author_facet | Prisco, L Citerio, G |
| author_sort | Prisco, L |
| collection | OXFORD |
| description | The need for a reliable neurological evaluation in severely brain-injured patients conflicts with sedation, which is routinely administered. Helbok and colleagues prospectively evaluated in a small cohort of 20 sedated severely brain-injured patients the effects of a wakeup test on intracranial pressure (ICP), brain tissue oxygen tension and brain metabolism. The test has been considered potentially risky on 34% of the study days. When the test is performed, ICP and cerebral perfusion pressure increase, usually slightly, except in a subgroup of patients with lower cerebral compliance where marked ICP and cerebral perfusion pressure changes were recorded. In this cohort, the information gained with the wake-up test has been negligible. Given the current little knowledge about the benefits of interruption of continuous sedation in brain-injured patients, it is extremely important to adopt multiple monitoring modalities in neurocritical care in order to escape wake-up tests in those patients who will potentially be harmed by this procedure. Once the clinical condition will improve, sedation needs to be tapered and suspended as soon as possible. |
| first_indexed | 2024-03-07T03:21:37Z |
| format | Journal article |
| id | oxford-uuid:b7a1044b-42be-46a8-9b46-20c9f35be287 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T03:21:37Z |
| publishDate | 2012 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:b7a1044b-42be-46a8-9b46-20c9f35be2872022-03-27T04:49:59ZTo wake-up, or not to wake-up: that is the Hamletic neurocritical care question!Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b7a1044b-42be-46a8-9b46-20c9f35be287Symplectic Elements at OxfordBioMed Central2012Prisco, LCiterio, GThe need for a reliable neurological evaluation in severely brain-injured patients conflicts with sedation, which is routinely administered. Helbok and colleagues prospectively evaluated in a small cohort of 20 sedated severely brain-injured patients the effects of a wakeup test on intracranial pressure (ICP), brain tissue oxygen tension and brain metabolism. The test has been considered potentially risky on 34% of the study days. When the test is performed, ICP and cerebral perfusion pressure increase, usually slightly, except in a subgroup of patients with lower cerebral compliance where marked ICP and cerebral perfusion pressure changes were recorded. In this cohort, the information gained with the wake-up test has been negligible. Given the current little knowledge about the benefits of interruption of continuous sedation in brain-injured patients, it is extremely important to adopt multiple monitoring modalities in neurocritical care in order to escape wake-up tests in those patients who will potentially be harmed by this procedure. Once the clinical condition will improve, sedation needs to be tapered and suspended as soon as possible. |
| spellingShingle | Prisco, L Citerio, G To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title | To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title_full | To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title_fullStr | To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title_full_unstemmed | To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title_short | To wake-up, or not to wake-up: that is the Hamletic neurocritical care question! |
| title_sort | to wake up or not to wake up that is the hamletic neurocritical care question |
| work_keys_str_mv | AT priscol towakeupornottowakeupthatisthehamleticneurocriticalcarequestion AT citeriog towakeupornottowakeupthatisthehamleticneurocriticalcarequestion |