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SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
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Reflections on Consciousness in Intensive Care.

Michael Broomé1,2, Tiit Mathiesen3,4,5

  • 1Department of Physiology and Pharmacology, Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|November 8, 2025
PubMed
Summary
This summary is machine-generated.

Accurate consciousness assessment in intensive care is crucial for patient care and prognosis. This review covers monitoring, treatments, and ethical issues for disorders of consciousness.

Keywords:
consciousnessethicsintensive caremonitoringsedationwithdrawal

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Area of Science:

  • Neuroscience
  • Intensive Care Medicine
  • Clinical Neurology

Background:

  • Assessing consciousness in intensive care is vital for managing pain and improving patient prognosis.
  • Current methods often equate consciousness with motor responsiveness, leading to diagnostic errors, especially in pediatric patients.
  • Misdiagnosis of coma occurs in over 15% of cases, highlighting the need for improved evaluation techniques.

Purpose of the Study:

  • To review current monitoring techniques for disorders of consciousness.
  • To discuss potential treatments and ethical considerations for patients with impaired consciousness.
  • To present theoretical models of consciousness based on neuroanatomy and information processing.

Main Methods:

  • Narrative review of existing literature on consciousness assessment and disorders.
  • Exploration of neuroanatomical and information processing theories of consciousness.
  • Discussion of clinical implications for intensive care settings.

Main Results:

  • Standard clinical assessments of consciousness can be unreliable, with significant diagnostic error rates.
  • Advanced monitoring techniques and theoretical models offer potential improvements in understanding and managing consciousness disorders.
  • Ethical dilemmas surrounding consciousness assessment and treatment require careful consideration.

Conclusions:

  • Improved methods for evaluating consciousness are essential in intensive care to ensure accurate diagnosis and appropriate treatment.
  • Understanding the neurobiological basis of consciousness is key to advancing clinical practice.
  • Addressing the ethical dimensions of consciousness disorders is critical for patient-centered care.