Use of BRASS in sedated critically-ill patients as a predictable mortality factor: BRASS-ICU.

Neurological Research
Vincent LegrosPhilippe Mateu

Abstract

Objectives: To demonstrate that a BRASS score≥ 3 at admission of intubated, ventilated and sedated patients is predictive of mortalityMethods: we have realized an Observational prospective multicenter study.All Major patients without neurological history, admitted to ICU for a non-neurological cause, sedated and admitted under mechanical ventilation were included.Results: One hundred and ten patients were included, the BRASS score as well as the FOUR and RASS scores were collected.At day 28, patients with a BRASS score ≥ 3 had an excess mortality (OR 3.29 - CI 95% [1.42-7.63], p = 0.005) as well as day 90 (OR 2.65 - CI 95% [1.19-5.88], p = 0.02), without impact on the delirium measured by CAM-ICU (OR 1.8 - CI 95% [0.68-4.77], p = 0.023). After adjustment with SAPS II, FOUR and RASS, difference in mortality was not any more different.It is also noted that patients with BRASS ≥ 3 are more sedated (RASS: -5 [-5 - -5] vs -4 [-5 - -3], p < 0.0001) and more comatose (FOUR: 2 [1-4] vs 6 [4-9], p < 0.0001), and have higher doses of midazolam (10 mg/h [5-15] vs 7.5 mg/h [5-10], p = 0.02) and sufentanil (20 μg/h [15-22.5] vs 10 [10-12.5], p = 0.01).Conclusions: The early alteration of brainstem reflexes measured by the BRASS score was no...Continue Reading

References

Aug 3, 1999·American Journal of Respiratory and Critical Care Medicine·D AnnaneP Gajdos
May 18, 2000·The New England Journal of Medicine·J P KressJ B Hall
Jan 5, 2002·Critical Care Clinics·G AngeliniD B Coursin
Oct 24, 2002·Critical Care Medicine·Tarek SharsharDjillali Annane
Nov 8, 2002·American Journal of Respiratory and Critical Care Medicine·Curtis N SesslerR K Elswick
Jun 12, 2003·JAMA : the Journal of the American Medical Association·E Wesley ElyGordon R Bernard
Mar 5, 2004·Brain Pathology·Tarek SharsharGray Françoise
Jul 16, 2009·Critical Care Medicine·Miriam M TreggiariNoel S Weiss
May 3, 2011·Critical Care Medicine·Tarek SharsharUNKNOWN Paris-Ouest Study Group on Neurological Effect of Sedation (POSGNES)
Aug 4, 2012·American Journal of Respiratory and Critical Care Medicine·Yahya ShehabiUNKNOWN ANZICS Clinical Trials Group
Nov 28, 2012·JAMA : the Journal of the American Medical Association·Sangeeta MehtaUNKNOWN Canadian Critical Care Trials Group
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
Dec 11, 2014·Critical Care Medicine·Sangeeta MehtaUNKNOWN Canadian Critical Care Trials Group
May 1, 2015·Critical Care : the Official Journal of the Critical Care Forum·Felix BalzerMarc Kastrup
Apr 26, 2017·PloS One·Benjamin RohautUNKNOWN Groupe d’Exploration Neurologique en Réanimation (GENER)

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.