![]() The size and reactivity to light of each pupil allows an exploration of brainstem function and should be recorded periodically in intensive care units (ICU) ( 2- 4). Pupillary examination is a key element of neurologic surveillance in critically ill patients ( 1). Keywords: Intensive care pupillary areflexia anisocoria ipratropium Bernard Horner Syndrome ![]() Interestingly, 9 (7%) PAs were attributed to ipratropium nebulization in patients with chronic obstructive pulmonary disease exacerbation.Ĭonclusions: The high prevalence of PAs, frequently associated with both brain organic lesions and drug side effects, highlights the clinical interest of pupillary surveillance in non-selected critically ill patients. The etiologies of the PAs at admission did not differ from those occurring during ICU stay (P=NS). Among the PAs, 59 (46%) were present upon ICU admission. The main causes of PAs were related to acute brain ischemia (n=41, 32%) and sedation/analgesia (n=50, 39%). A total of 128 PAs were recorded in 109 patients: 78 areflexia alone (61%), 33 anisocoria alone (26%) and 17 (13%) with associated anisocoria and areflexia. ![]() The majority of patients (n=161, 54%) were admitted to the ICU for acute respiratory or cardiovascular failure. Results: During the study period, we included 297 patients who had 6☙ pupillary examinations per day (totaling 11,360 pupillary assessments). PA was defined as areflexia and/or anisocoria present at the time of ICU admission or occurring during the ICU stay. All patients with at least one pupillary examination were included. Methods: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. Interviews with Outstanding Guest Editorsīackground: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU).Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process.
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