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Published on: February 6, 2021
Delayed awakening in neurocritical care
E Bouchereau1, T Sharshar1, C Legouy2
1G.H.U Paris Psychiatry & Neurosciences, department of Neurocritical care, Service d'Anesthésie-Réanimation Neurochirurgicale, 1, rue Cabanis, 75674 Paris Cedex 14, France; INSERM U1266, FHU NeuroVasc, Institut de Psychiatrie et Neuroscience de Paris, Paris, France.
Abstract:
Delayed awakening is defined as a persistent disorder of arousal or consciousness 48 to 72h after sedation interruption in critically ill patients. Delayed awakening is either a component of coma or delirium. It results in longer hospital stays and increased mortality. It is therefore a diagnostic, therapeutic and prognostic emergency. In severe brain injured patients, delayed awakening may be related to the primary neurological injury or to secondary systemic insults related to organ failure associated with intensive care. In the present review, we propose diagnostic, therapeutic and prognostic algorithms for managing delayed awaking in neuro-ICU brain injured patients.
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