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Manifestations of Critical Illness Brain Injury

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Annual Update in Intensive Care and Emergency Medicine 2020

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

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Abstract

Critical illness brain injury is an acute form of brain dysfunction affecting the level of consciousness, cognition and/or psychomotor functioning. Such injury is associated with prolonged mechanical ventilation requirements, longer intensive care unit (ICU) stays, increased long-term mortality, and long-term cognitive impairment among survivors. Commonly recognized manifestations include delirium, characterized by fluctuating levels of arousal and inability to maintain attention, and coma, characterized by unarousable unresponsiveness to external stimuli. Recent work has shed light on catatonia as a third potential manifestation of critical illness brain injury. Catatonia is a syndrome of abnormal psychomotor function, volition, and behavior. Its presentation may overlap with that of delirium or coma, or be fully distinct. This chapter offers a brief overview of these three important manifestations of critical illness brain injury and provides a conceptual framework for their interrelationships. Recognition, appropriate assessment, and disambiguation of these syndromes of brain injury are critically important aspects of ICU care.

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Author information

Authors and Affiliations

  1. Center for Critical Illness, Brain Dysfunction and Survivorship, Vanderbilt University Medical Center, Nashville, TN, USA

    S. Williams Roberson, E. W. Ely & J. E. Wilson

  2. Department of Neurology, Epilepsy Division, Vanderbilt University Medical Center, Nashville, TN, USA

    S. Williams Roberson

  3. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    E. W. Ely

  4. Veteran’s Affairs TN Valley, Geriatrics Research, Education and Clinical Center (GRECC), Nashville, TN, USA

    E. W. Ely

  5. Department of Psychiatry and Behavioral Sciences, Division of General Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA

    J. E. Wilson

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  1. S. Williams Roberson
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  2. E. W. Ely
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Correspondence to S. Williams Roberson .

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Editors and Affiliations

  1. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Williams Roberson, S., Ely, E.W., Wilson, J.E. (2020). Manifestations of Critical Illness Brain Injury. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2020. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-37323-8_35

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  • DOI: https://doi.org/10.1007/978-3-030-37323-8_35

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-37322-1

  • Online ISBN: 978-3-030-37323-8

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