在ICU的秘密意识.
Brian L Edlow1,2, David K Menon3
1Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Critical care medicine
|August 15, 2024
概括
通过先进的神经成像检测到的隐藏意识存在于15-20%的严重脑损伤的不反应ICU患者中. 这一发现影响了预后和治疗决策,指导了维持生命的治疗讨论.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 神经成像是一种神经成像.
背景情况:
- 患有严重脑损伤的重症患者可能表现出隐藏的意识 (认知运动解离),尽管表现出行为不响应.
- 功能性MRI (fMRI) 和电脑电图 (EEG) 等先进的神经技术可以检测出这种隐藏的意识.
研究的目的:
- 审查目前关于在重症监护室 (ICU) 检测隐藏意识的科学理解.
- 探索识别隐藏意识的预后和治疗影响.
- 为了为有关严重脑损伤患者的维持生命治疗的讨论提供信息.
主要方法:
- 一个对突出的医学文献的叙事评论.
- 包括基于任务的fMRI和EEG的诊断性能和预后实用性的临床研究.
- 专注于临床指导方针,专业协会声明和ICU实施的神经伦理分析.
主要成果:
- 在大约15-20%的严重脑损伤 (创伤和非创伤) 的不响应ICU患者中检测到隐藏的意识.
- 隐藏意识的存在可以预测长期的功能恢复.
- 专业协会建议使用fMRI和EEG来评估隐藏的意识.
结论:
- 虽然指导方针建议先进的神经成像用于隐藏意识,但患者选择标准仍然不清楚.
- 全球对神经技术的获取有限,这对广泛实施构成了挑战.
- 诊断隐藏意识在重症监护中具有显著的预后和治疗意义.
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