Are circadian rhythms in disarray in patients with chronic critical illness?

Aim: The aim of our study is to assess circadian rhythms in patients with chronic critical illness due to severe brain injury in intensive care unit by establishing the relation between melatonin and cortisol secretion, considering astronomical time and the sleep-wake cycle in chronic critical illness.

Materials And Methods: The study included 54 adult patients with chronic critical illness who resided in the intensive care unit for at least 30 days. The level of consciousness was determined using the CRS-R scale.

Two-year outcomes of patients with prolonged disorders of consciousness: a prospective cohort study in Russian Federation.

Background: Epidemiological data on prolonged disorders of consciousness (pDOC) are not available due to lack of research in this field. The objective of this pioneering prospective cohort study in the Russian Federation was to collect the data on the survival and the level of consciousness of patients with pDOC, as well as to search for prognostic markers of survival and improvement of the level of consciousness on long-terms outcomes (up to 24 months).

Methods: All patients (n=184) had pDOC and were admitted to the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology.

One-Year Demographical and Clinical Indices of Patients with Chronic Disorders of Consciousness.

This work aims to evaluate the prognostic value of the demographical and clinical data on long-term outcomes (up to 12 months) in patients with severe acquired brain injury with vegetative state/unresponsive wakefulness syndrome (VS/UWS/UWS) or a minimally conscious state (MCS). Patients ( = 211) with VS/UWS/UWS ( = 123) and MCS ( = 88) were admitted to the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology after anoxic brain injury ( = 53), vascular lesions ( = 59), traumatic brain injury ( = 93), and other causes ( = 6). At the beginning of the 12-month study, younger age and a higher score by the Coma Recovery Scale-Revised (CRS-R) predicted a survival.

Effect of Retinohypothalamic Tract Dysfunction on Melatonin Level in Patients with Chronic Disorders of Consciousness.

Objective: The aim of this study is to compare the secretion level of nocturnal melatonin and the characteristics of the peripheral part of the visual analyzer in patients with chronic disorders of consciousness (DOC).

Materials And Methods: We studied the level of melatonin in 22 patients with chronic DOC and in 11 healthy volunteers. The fundus condition was assessed using the ophthalmoscopic method.

Retrospective analysis of sleep patterns in patients with chronic disorders of consciousness.

Analysis of sleep patterns in patients with chronic disorders of consciousness attracts attention from the perspective of the diagnosis and prognosis of the disease as well as the treatment. Yet, the very existence of normal sleep in patients in a vegetative or minimally conscious state is still a matter of debate. This paper presents a retrospective analysis of overnight polysomnographic records of 40 patients with chronic disorders of consciousness aimed at the possibility of establishing the connection between the degree of impaired consciousness and the presence and organization of polysomnographic graphical elements, associated with stages of sleep in normal individuals.