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01-04-2014 | Conference Reports and Expert Panel

Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel

Authors: Tarek Sharshar, Giuseppe Citerio, Peter J. D. Andrews, Arturo Chieregato, Nicola Latronico, David K. Menon, Louis Puybasset, Claudio Sandroni, Robert D. Stevens

Published in: Intensive Care Medicine | Issue 4/2014

Abstract

Objective

Many patients admitted to the intensive care unit (ICU) have pre-existing or acquired neurological disorders which significantly affect their short-term and long-term outcomes. The ESICM NeuroIntensive Care Section convened an expert panel to establish a pragmatic approach to neurological examination (NE) of the critically ill patient.

Methods

The group conducted a comprehensive review of published studies on the NE of patients with coma, delirium, seizures and neuromuscular weakness in critically ill patients. Quality of data was rated as high, moderate, low, or very low, and final recommendations as strong, weak, or best practice.

Summary and Conclusions

The group made the following recommendations: (1) NE should be performed in all patients admitted to ICUs; (2) NE should include an assessment of consciousness and cognition, brainstem function, and motor function; (3) sedation should be managed to maximize the clinical detection of neurological dysfunction, except in patients with reduced intracranial compliance in whom withdrawal of sedation may be deleterious; (4) the need for additional tests, including neurophysiological and neuroradiological investigations, should be guided by the NE; (5) selected features of the NE have prognostic value which should be considered in well-defined patient populations.

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Title: Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel
Authors: Tarek Sharshar
Giuseppe Citerio
Peter J. D. Andrews
Arturo Chieregato
Nicola Latronico
David K. Menon
Louis Puybasset
Claudio Sandroni
Robert D. Stevens
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 4/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-014-3214-y

At a glance: The STEP trials

Springer Medicine

Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel

Abstract

Objective

Methods

Summary and Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Summary and Conclusions

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