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PubMed · 2099638

[Traumatic coma awakening unit].

Abstract

Clinique Saint Martin is a specialized center for neurologic rééducation which disposes since the month of May 1989 of a ten beds unit intended to receive head injury during coma awakening stage (as soon as possible after intensive care). Effectively important clinical troubles are in relation with traumatism and coma but also secondary effects seems to be due to a long stay in Intensive Care Unit (in spite of all qualities of the medical team). Every patient has a room which can be personified and become very familiar for purpose to create a safe surrounding, without movement limitation and rich in sensorial stimulations and human contacts. Team for each patient is very numerous. In very intensive and permanent way the first period is distinguished by the need of a presence. Repeated calls "for nothing" are characteristic of coma awakening and must count in the unit working.

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BibTeXRIS

H Curallucci, H Alessandri. 1990. [Traumatic coma awakening unit].. https://pubmed.ncbi.nlm.nih.gov/2099638/

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Predicting coma and other low responsive patients outcome using event-related brain potentials: a meta-analysis.

OBJECTIVE: A meta-analysis was performed to estimate the predictive power (odd ratio, OR) for awakening of auditory event-related potential (ERP) components in low responsive patients with stroke or hemorrhage, trauma, anoxic, post-operative, and metabolic encephalopathy etiologies. METHODS: We reviewed MEDLINE and analyzed citations for retrieved articles. Logistic regressions were applied on patient samples (Glasgow Coma Scale <12) across and for separate etiologies. RESULTS: For stroke and hemorrhage the ORs with 95% confidence intervals were: 2.05 [1.12-3.75] (N100), 4.47 [1.92-10.44] (MMN), 10.29 [2.00-52.79] (P300), for trauma: 1.63 [0.70-3.80] (N100), 4.72 [1.35-16.44] (MMN), 12.89 [4.82-34.43] (P300), anoxic: 8.03 [2.83-22.75] (N100), 15.50 [4.27-56.26] (MMN), 5.93 [2.38-14.77] (P300), post-operative: 10.66 [1.98-57.50] (N100), metabolic encephalopathy: 2.12 [0.34-13.13] (N100), 3.60 [0.28-46.36] (MMN), 7.71 [0.75-79.77] (P300), and all etiologies: 2.85 [1.91-4.27] (N100), 6.53 [3.55-12.01] (MMN), and 8.79 [4.88-15.83] (P300). Based on six N100 studies (N=548 patients), five MMN studies (N=470), and six P300 studies (N=313), the N100, MMN, or P300, when present, significantly predicted awakening, P300 and MMN being significantly better predictors than N100. CONCLUSIONS: The MMN and P300 appear to be reliable predictors of awakening. SIGNIFICANCE: The prognostic assessment of low responsive patients with auditory ERP should take into account both MMN and P300.

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