Evidence map›Paper›PMID 41396553›Full record

ReviewIntensive care medicine2026

Disorders of consciousness diagnosis, interventions, and prognostication for the intensivist: Report of the 2025 ISICEM roundtable.

Yelena G Bodien, Katharina M Busl, Cherylee W J Chang, Jan Claassen, Nicolas Gaspard, Olivia Gosseries, Raimund Helbok, Marcello Massimini, Lionel Naccache, Virginia Newcombe and 8 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Article
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  5. Review
  6. How we use the neurological pupil index (NPi).Critical care (London, England) · 2026
    Article
  7. Review
  8. Review
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  11. Article
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  13. Review
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  19. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Yelena G BodienCritical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, USA. yelena.bodien@vumc.org.ORCID 0000-0003-4858-2903
Katharina M BuslDivision of Neurocritical Care, Departments of Neurology and Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA.ORCID 0000-0001-9961-0527
Cherylee W J ChangDivision of Neurocritical Care, Departments of Neurology, Neurosurgery, Medicine, Duke University, Durham, NC, USA.
Jan ClaassenDivision of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, USA.ORCID 0000-0002-5893-8531
Nicolas GaspardService de Neurologie, Hôpital Universitaire de Bruxelles-Université Libre de Bruxelles, Brussels, Belgium.
Olivia GosseriesComa Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium.ORCID 0000-0001-9011-7496
Raimund HelbokDepartment of Neurology, Kepler University Hospital, Johannes Kepler University, Linz, Austria.ORCID 0000-0001-5682-0145
Marcello MassiminiDepartment of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Lionel NaccacheDMU Neurosciences-Clinical Neurophysiology, Paris Brain Institute-ICM, Inserm, CNRS, PICNIC-Lab, Sorbonne Université, APHP, Hôpital de La Pitié Salpêtrière, Paris, France.
Virginia NewcombeDepartment of Medicine, University of Cambridge, Cambridge, UK.ORCID 0000-0001-6044-9035
Chiara RobbaIRCCS Policlinico San Martino, Genoa, Italy.
Benjamin RohautDMU Neurosciences-Neuro ICU, Inserm, CNRS, PICNIC-Lab, Paris Brain Institute-ICM, Sorbonne Université, APHP, Hôpital de La Pitié Salpêtrière, Paris, France.
Jose I SuarezDivision of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Alexis F TurgeonPopulation Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec-Université Laval Research Center, Université Laval, Québec City, QC, Canada.
Paul VespaDepartments of Neurosurgery and Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Sarah WahlsterDepartments of Neurology, Neurosurgery, and Anesthesiology, Harborview Medical Center, University of Washington, Washington, USA.
Fabio Silvio TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Giuseppe CiterioSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.ORCID 0000-0002-5374-3161

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Disorders of consciousness (DoC) represent a spectrum of clinical conditions, including coma, unresponsive wakefulness syndrome, and the minimally conscious state, which may result from structural and non-structural brain injuries due to trauma, stroke, anoxia, infections of the brain, and other causes. Clinical management of patients with DoC is especially challenging in the critical care environment, where the level of consciousness, a key factor in determining the trajectory of recovery, may be obscured by sedation, analgesia, and other confounders. The 2025 International Symposium on Intensive Care and Emergency Medicine hosted a Roundtable of 18 expert clinicians and researchers to synthesise and discuss the latest evidence on acute DoC epidemiology, diagnosis, treatment, and prognosis. Here, we summarise the output of the Roundtable in the format of a roadmap with six steps related to identifying patients with DoC, assessing for and treating confounders, establishing a diagnosis and prognosis, selecting interventions, and effectively communicating with family. This roadmap provides practical, evidence-informed guidance to help intensivists navigate diagnosis, treatment, and prognostication in patients with acute DoC. Advances in structural and functional neuroimaging, electrophysiology, and blood-based biomarkers offer promise for refined diagnostics and prognostication, though their clinical translation remains limited.

Indexed as

Consciousness DisordersCritical CareHumansIntensive Care UnitsPrognosisAcute brain injuryCognitive motor dissociationComaDisorders of consciousnessEthical decision-makingIntensive careMinimally conscious stateNeuroprognosticationUnresponsive wakefulness syndromeVegetative state

Identifiers

PMID41396553
PMCPMC12852174

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.