Management of severe acute encephalopathy in the ICU: an expert consensus statement from the french society of intensive care medicine

Introduction Acute encephalopathy in the ICU poses significant diagnostic, therapeutic, and prognostic challenges. Standardized expert guidelines on acute encephalopathy are needed to improve diagnostic methods, therapeutic decisions, and prognostication. Methods The experts conducted a review of th...

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Veröffentlicht in:Annals of intensive care Jg. 15; H. 1; S. 37 - 18
Hauptverfasser: Sonneville, Romain, Azabou, Eric, Bailly, Pierre, Benghanem, Sarah, De Almeida Cardoso, Gilles, Claquin, Pierre, Cortier, David, Gaudemer, Augustin, Hermann, Bertrand, Jaquet, Pierre, Lambrecq, Virginie, Legouy, Camille, Legriel, Stéphane, Rambaud, Thomas, Rohaut, Benjamin, Sarton, Benjamine, Silva, Stein, Sharshar, Tarek, Taccone, Fabio Silvio, Vodovar, Dominique, Weiss, Nicolas, Cerf, Charles
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Cham Springer International Publishing 21.03.2025
Springer Nature B.V
SpringerOpen
Schlagworte:
Agreements
Anesthesiology
Coma
Critical Care Medicine
Delirium
Emergency Medicine
Intensive
Intensive care
Life Sciences
Medicine
Medicine & Public Health
Patients
Review
Evidence-Based Medicine
Neurointensive care
Acute care
Best practice
Grading (engineering)
ISSN:2110-5820, 2110-5820
Online-Zugang:Volltext
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Zusammenfassung:Introduction Acute encephalopathy in the ICU poses significant diagnostic, therapeutic, and prognostic challenges. Standardized expert guidelines on acute encephalopathy are needed to improve diagnostic methods, therapeutic decisions, and prognostication. Methods The experts conducted a review of the literature, analysed it according to the GRADE (Grading of Recommendation, Assessment, Development and Evaluation) methodology and made proposals for guidelines, which were rated by other experts. Only expert opinions with strong agreement were selected. Results The synthesis of expert work and the application of the GRADE method resulted in 39 recommendations. Among the 39 formalized recommendations, 1 had a high level of evidence (GRADE 1 +) and 10 had a low level of evidence (GRADE 2 + or 2-). These recommendations describe indication for ICU admission, use of clinical scores and EEG for diagnosis, detection of complications, and prognostication. The remaining 28 recommendations were based on expert consensus. These recomandations describe common indications for blood and CSF studies, neuroimaging, use of neuromonitoring, and provide guidelines for management in the acute phase. Conclusion This expert consensus statement aims to provide a structured framework to enhance the consistency and quality of care for ICU patients presenting with acute encephalopathy. By integrating high-quality evidence with expert opinion, it offers a pragmatic approach to addressing the complex nature of acute encephalopathy in the ICU, promoting best practices in patient care and facilitating future research in the field.
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ISSN:2110-5820
2110-5820
DOI:10.1186/s13613-025-01436-0