International survey on the implementation of the European and American guidelines on disorders of consciousness.

International survey on the implementation of the European and American guidelines on disorders of consciousness.

Publication date: Sep 23, 2023

Diagnostic, prognostic, and therapeutic procedures for patients with prolonged disorders of consciousness (pDoCs) vary significantly across countries and clinical settings, likely due to organizational factors (e. g., research vs. non-academic hospitals), expertise and availability of resources (e. g., financial and human). Two international guidelines, one from the European Academy of Neurology (EAN) and one from the American Academy of Neurology (AAN) in collaboration with the American Congress of Rehabilitation Medicine (ACRM) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), were developed to facilitate consistent practice among professionals working with this challenging patient population. While the recommendations of both guidelines agree in principle, it remains an open issue how to implement them into clinical practice in the care pathway for patients with pDoCs. We conducted an online survey to explore health professional clinical practices related to the management of patients with pDoCs, and compare said practices with selected recommendations from both the guidelines. The survey revealed that while some recommendations are being followed, others are not and/or may require more honing/specificity to enhance their clinical utility. Particular attention should be given to the implementation of a multimodal assessment of residual consciousness, to the detection and treatment of pain, and to the impact of restrictions imposed by COVID-19 pandemics on the involvement of patients’ families/representatives.

Open Access PDF

Concepts Keywords
Academic Bioethics
European Clinical guidelines
Hospitals Cognitive–motor dissociation
Pandemics Coma
Therapeutic Disorders of consciousness
Minimally conscious state
Unresponsive wakefulness syndrome
Vegetative states


Type Source Name
disease MESH disorders of consciousness
disease VO population
disease MESH COVID-19 pandemics
disease MESH Coma
disease MESH syndrome
disease MESH dissociation
disease VO effective
disease VO USA
drug DRUGBANK Coenzyme M
disease VO protocol
disease VO frequency
drug DRUGBANK Tilmicosin
disease MESH etiology
disease IDO process
drug DRUGBANK Trestolone
disease MESH uncertainty
disease VO Apa
disease IDO facility
disease VO effectiveness
disease MESH complications
disease IDO history
disease MESH infection
disease VO time
disease VO organization
disease MESH clinical relevance
drug DRUGBANK Sulpiride
drug DRUGBANK Gold
drug DRUGBANK Aspartame
disease VO efficient
disease MESH minimally conscious state
disease VO URE
disease MESH Unconsciousness
disease MESH akinetic mutism
disease IDO country
disease MESH communicative disorders
disease VO Canada

Original Article

(Visited 1 times, 1 visits today)