PURPOSE: To evaluate whether pupillary abnormalities would correlate with the severity of encephalopathy in critically ill cirrhotic patients. METHODS: In this retrospective study, we enrolled adult cirrhotic patients admitted to the Intensive Care Unit undergoing automated pupillometry assessment within the first 72 h since ICU admission. Encephalopathy was assessed with West-Haven classification and Glasgow Coma Scale. Pupillometry-derived variables were also correlated with biological variables, including ammonium, renal function or inflammatory parameters, measured on the day of pupillary assessment. RESULTS: A total of 62 critically ill cirrhotic patients (Age 61 [52-68] years; 69% male) were included. Median GCS and West-Haven classification were 14 [11-15] and 1 [0-3], respectively. There was a significant although weak correlation between GCS and constriction velocity (CV; R2 = 0.1; p = 0.017). We observed significant differences in CV and DV values among different levels of West-Haven classification. When only patients with encephalopathy (n = 42) or severe HE (n = 18) were considered, a weak correlation between GCS and worst CV was observed. When patients receiving sedatives or opioids were excluded, no significant correlation between pupillometry and clinical variables was observed. CONCLUSIONS: Pupillary function assessed by the automated pupillometry was poorly associated with encephalopathy scales in cirrhotic patients.
PURPOSE: To evaluate whether pupillary abnormalities would correlate with the severity of encephalopathy in critically ill cirrhoticpatients. METHODS: In this retrospective study, we enrolled adult cirrhotic patients admitted to the Intensive Care Unit undergoing automated pupillometry assessment within the first 72 h since ICU admission. Encephalopathy was assessed with West-Haven classification and Glasgow Coma Scale. Pupillometry-derived variables were also correlated with biological variables, including ammonium, renal function or inflammatory parameters, measured on the day of pupillary assessment. RESULTS: A total of 62 critically ill cirrhoticpatients (Age 61 [52-68] years; 69% male) were included. Median GCS and West-Haven classification were 14 [11-15] and 1 [0-3], respectively. There was a significant although weak correlation between GCS and constriction velocity (CV; R2 = 0.1; p = 0.017). We observed significant differences in CV and DV values among different levels of West-Haven classification. When only patients with encephalopathy (n = 42) or severe HE (n = 18) were considered, a weak correlation between GCS and worst CV was observed. When patients receiving sedatives or opioids were excluded, no significant correlation between pupillometry and clinical variables was observed. CONCLUSIONS: Pupillary function assessed by the automated pupillometry was poorly associated with encephalopathy scales in cirrhotic patients.
Authors: Lorenzo Peluso; Lorenzo Ferlini; Marta Talamonti; Narcisse Ndieugnou Djangang; Elisa Gouvea Bogossian; Marco Menozzi; Filippo Annoni; Elisabetta Macchini; Benjamin Legros; Paolo Severgnini; Jacques Creteur; Mauro Oddo; Jean-Louis Vincent; Nicolas Gaspard; Fabio Silvio Taccone Journal: Front Neurol Date: 2022-03-21 Impact factor: 4.003