Chronic disorders of consciousness: terminology and diagnostic criteria. The results of the first meeting of the Russian Working Group for Chronic Disorders of Consciousness

Piradov, M.; Mikhail, A Piradov; Супонева, Н. А.; Natalya, A Suponeva; Voznyuk, I. A.; Igor, A Voznyuk; Kondratyev, A. N.; Anatoly, N Kondratyev; Shchegolev, Alexey V.; Alexey, V Shchegolev; Belkin, Andrey; Andrey, Antoine; Zaitsev, Oleg; Олег, Скугаревский; Pryanikov, I.V.; Igor, V Pryanikov; Petrova, Marina V.; Marina, V Petrova; Иванова, Н. Е.; Natalia, E Ivanova; Gnedovskaya, E. V.; Elena, V Gnedovskaya; Ryabinkina, Yu. V.; Yulia, V Ryabinkina; Сергеев, Д.В.; Dmitry, V Sergeev; Yazeva, Elizaveta G.; Elizaveta, G Yazeva; Legostaeva, L.; Liudmila, A Legostaeva; Fufaeva, Ekaterina V.; Ekaterina, V Fufaeva; Петриков, С. С.; Sergey, S Petrikov

doi:10.25692/acen.2020.1.1

Cited by 20 publications

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“…After emerging from a coma, patients who have experienced severe brain damage often pass into a state of chronic disorder of consciousness (DOC) for an indefinite term, including a vegetative state (VS) and minimally conscious state (MCS) [ 1 , 2 , 3 ]. The increase in the number of these patients induces significant social and economic problems, complicated by a lack of detailed understanding regarding diagnosis, prediction of outcomes, and determination of the principles of therapy and rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Correction of Local Brain Temperature after Severe Brain Injury Using Hypothermia and Medical Microwave Radiometry (MWR) as Companion Diagnostics

et al. 2023

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The temperature of the brain can reflect the activity of its different regions, allowing us to evaluate the connections between them. A study involving 111 patients in a vegetative state or minimally conscious state used microwave radiometry to measure their cortical temperature. The patients were divided into a main group receiving a 10-day selective craniocerebral hypothermia (SCCH) procedure, and a control group receiving basic therapy and rehabilitation. The main group showed a significant improvement in consciousness level as measured by CRS-R assessment on day 14 compared to the control group. Temperature heterogeneity increased in patients who received SCCH, while remaining stable in the control group. The use of microwave radiometry to assess rehabilitation effectiveness and the inclusion of SCCH in rehabilitation programs appears to be a promising approach.

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Section: Introductionmentioning

confidence: 99%

Correction of Local Brain Temperature after Severe Brain Injury Using Hypothermia and Medical Microwave Radiometry (MWR) as Companion Diagnostics

et al. 2023

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“…В структуре последствий перенесенной черепномозговой травмы (ЧМТ) немаловажное место занимает такое осложнение, как хроническое нарушение сознания (ХНС). ХНС представляют собой состояния, развивающиеся после тяжелого повреждения головного мозга травматического и нетравматического генеза и характеризующиеся восстановлением бодрствования после комы, которое не сопровождается восстановлением сознания [1,2]. Данные по распространенности вегетативного состояния в разных странах по результатам одних исследований составляют от 0,6 до 10%, в среднем 7% [3], по данным других источников -2,7% [4].…”

Section: Introductionunclassified

Effects of Xenon on Neuroinflammatory Markers: a Prospective Pilot Study

Shpichko

Черпаков²,

Шабанов³

et al. 2023

Neotložnaâ med. pomoŝʹ

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The leading role of neuroinflammation as the culprit of a long-term impairment of consciousness in patients after injuries to the central nervous system forces us to look for new effective strategies for resolving this pathological process. Xenon reducing the intensity of the inflammatory response due to the impact on several links is potentially able to have a beneficial effect on this category of patients. Using laboratory equipment, we evaluated the effect of half-hour daily inhalations of a 30% air mixture with 30% xenon for 7 days on the level of markers of neuronal damage and regeneration of nervous tissue.AIM To study the effect of inhalation of an air-xenon mixture on the dynamics of markers of neuroinflammation and restoration of nervous tissue in patients after traumatic brain injury (TBI).MATERIAL AND METHODS We conducted a prospective randomized clinical trial evaluating the effect of inhaled xenon for sedation on the level of consciousness and spasticity in patients with prolonged post-coma impairment of consciousness. Patients were randomized into 2 equal groups. In Group I (Comparison, n=15) in addition to the standard treatment for TBI, each patient included in the study underwent 7 sessions of inhalation of an air mixture with an oxygen content of at least 30 vol.% for 30 minutes. In Group II (Xenon, n=15) in addition to the standard treatment, each patient included in the study underwent a half-hour inhalation with an air-xenon gas mixture (with a xenon content of 30 vol.% and oxygen — 30 vol.%) for 7 days, 1 time per day. The levels of interleukin-6, α-1 acid glycoprotein (AGP), S100 b protein and brain-derived neurotrophic factor were assessed before the first treatment and then once a day for 6 days.RESULTS The final evaluation included 12 patients from the Comparison Group and 12 patients from the Xenon Group. The greatest difference in the concentration of interleukin-6 between the Comparison and Xenon Groups was noted on the 5th day - 12.31 (10.21; 15.43) pg/ml vs. 7.93 (3.61; 9.27) pg/ml, respectively; however, the findings only tended to be statistically significant (p=0.07). When assessing the AGP level, the maximum difference was noted on the 4th day. In the Comparison Group, the AGP level was 0.81 (0.74; 0.92) pg/ml versus 0.614 (0.4; 0.79) pg/ml in the Xenon Group. And again, the data showed only a trend towards statistical significance (p=0.09). The highest level of brain-derived neurotrophic factor in the Xenon Group was observed on the 3th day — 0.1271 (0.046; 0.2695) pg/ml, which was statistically significantly higher than the one in the Comparison Group — 0.062 (0.036; 0.121) pg/ml (p=0.04). The concentration of S100 b protein during the entire observation period in both groups did not exceed 0.005 pg/ml.CONCLUSION Xenon inhalation according to the method proposed by the authors had a beneficial effect on the processes of neural tissue regeneration, however, with regard to neuroinflammation, its effects were not so pronounced.

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“…This impairment is primarily associated with a toxic and metabolic effect on the brain, as well as with medications usually administered in intensive care and resuscitation units (ICRU). A special and probably the most common group is represented by the patients with marked alterations of consciousness having initial brain damage resulted from severe traumatic brain injury, ischemic or hemorrhagic reviews stroke, or after neurosurgical operations [3]. CCI begins in this category of patients with the time of brain impairment with various traumatic agents (ischemia, hemorrhage, traumas, hypoxia, etc.).…”

Section: Introductionmentioning

confidence: 99%

Chronic Critical Illness: Current Aspects of the Problem (Review)

Parfenov¹,

Razzhivin²,

Petrova³

2022

Sovrem Tehnol Med

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Chronic resuscitation patients who have survived the acute phase of a disease represent a fast-growing cohort of patients requiring specialized medical assistant in intensive care and resuscitation units (ICRU) for several months or years. The term "chronic critical illness" (CCI) was proposed for such patients in the mid-80s of the last century. Patients with CCI make up from 5 to 20% of ICRU. Over time, they develop homeostasis disorders resulting in multiple organ failure and death. Mortality in CCI exceeds that of the majority of malignant neoplasms and functional dependence remains in most of survivors.In the present review, the attempt is made to show the main links of CCI pathogenesis which, if acted upon, can prevent unfavorable outcome. The publications describing epidemiology of CCI, its outcomes, and clinical phenotype have been analyzed.Several researchers consider CCI as a result of persistent inflammation, immunosuppression, and catabolism syndrome. Some works show the importance of nutrition for ICRU patients. The role of gastrointestinal tract in CCI formation has been noted. The effect of intensive therapy on microbiota of the ICRU patients has been demonstrated. Microbiome disturbances in dysbiosis and sepsis have been considered, as well as the effect of intestinal microbiome on the distant organs.Post-intensive care syndrome is a significant constituent of CCI. The main sequelae of the syndrome, as well as the general questions of its prevention and treatment, have been denoted.

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Chronic disorders of consciousness: terminology and diagnostic criteria. The results of the first meeting of the Russian Working Group for Chronic Disorders of Consciousness

Cited by 20 publications

References 0 publications

Correction of Local Brain Temperature after Severe Brain Injury Using Hypothermia and Medical Microwave Radiometry (MWR) as Companion Diagnostics

Correction of Local Brain Temperature after Severe Brain Injury Using Hypothermia and Medical Microwave Radiometry (MWR) as Companion Diagnostics

Effects of Xenon on Neuroinflammatory Markers: a Prospective Pilot Study

Chronic Critical Illness: Current Aspects of the Problem (Review)

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