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[Septic encephalopathy--prognostic value of the intensity of consciousness disorder to the outcome of sepsis].

Septic encephalopathy (SE) is a common term indicating the development of signs of progressing cerebral dysfunction and is associated with the presence of microorganisms and their toxins in the blood. Aim of this investigation was to analyze the frequency of this complication considering the consciousness disorders in quantitative sense and prognosis of the survival in patients with SE. The investigation comprised patients (n = 54) with positive hemoculture and signs of septic syndrome by the accepted criteria (fever, clinical signs of infection, respiratory frequency, heart rate, plasma lactate, oliguria). Patients with confirmed cerebral injury, hemorrhage or cerebral ischemia were excluded from the study. Lumbar punction and CT-scan of the brain were performed in all patients in order to exclude visible lesions of cerebral parenchyma and eventual presence of cerebral nervous system (CNS) infection as the causes of sepsis. Results of the investigation demonstrated that in 30 (55%) of patients existed mild consciousness disorder at the level of somnolescence, in 18 (33%) consciousness disorder at the level of sopor and in 6 (11%) consciousness disorder at the level of deep coma. Level of consciousness disorder was in positive correlation with the outcome of sepsis syndrome, which was additionally confirmed by the fact that only in the group of patients with deep coma lethal outcome was observed in 3 cases (50% of this subgroup) regardless of intensive antibiotic, metabolically active and symptomatic therapy. It can be concluded that SE syndrome has a favorable prognosis if macroscopic lesion and dissemination of microorganisms in CNS are not present, and simultaneously it represents changes in metabolic-electrolytic state with early presentation of consciousness disorders that represent clinically significant indicator for sepsis syndrome outcome.

Aged↗
PubMed1981

[Compressed spectral EEG analysis in patients with consciousness disorders complicating stroke].

In 26 patients with stroke accompanied by consciousness disorders, 48 monitoring recordings of compressed spectral array of EEG were performed by means of computerised real-time fast Fourier transformation of initial EEG with digital assay of total spectral power and percentage of frequency components in the brain hemispheres. Bilateral increase in the total spectral power and in slow-wave spectral components correlated with diffuse alterations in the initial EEG. 3 types of spectrograms were distinguished in accordance with the degree of consciousness disorders. Possibilities and prospects for application of the new method in patients with stroke are discussed.

Adult↗
PubMed2003

Feasibility of swallowing interventions for tracheostomized individuals with severely disordered consciousness following traumatic brain injury.

PRIMARY OBJECTIVE: To report the ability of 12 tracheostomized acute rehabilitation hospital inpatients with severely disordered consciousness post-traumatic brain injury (TBI) to participate in an objective swallowing assessment. RESEARCH DESIGN: Post hoc analysis of data from a larger, prospective blinded comparison study. METHODS AND PROCEDURES: Subjects completed a modified barium swallow (MBS) study. Food/drink and tracheostomy tube management recommendations were made. MAIN OUTCOMES AND RESULTS: All subjects participated successfully during an MBS. Post-MBS, 10 subjects began receiving small amounts of food and/or drink. Prior to hospital discharge, all subjects received some food and/or drink and were extubated. Subjects were deemed representative of this patient population and, from a swallowing perspective, other tracheostomized patient populations at the same facility. CONCLUSIONS: Clinicians should routinely consider tracheostomized, acute rehabilitation hospital inpatients with severely disordered consciousness post-TBI potential MBS candidates. Implications and continued research needs are discussed.

Adult↗