For critically ill patients with acute severe brain injuries, consciousness may reemerge before behavioral responsiveness. The phenomenon of covert consciousness (i.e., cognitive motor dissociation) may be detected by advanced neurotechnologies such as task-based functional MRI (fMRI) and electroencephalography (EEG) in patients who appear unresponsive on the bedside behavioral examination. In this narrative review, we summarize the state-of-the-science in ICU detection of covert consciousness. Further, we consider the prognostic and therapeutic implications of diagnosing covert consciousness in the ICU, as well as its potential to inform discussions about continuation of life-sustaining therapy for patients with severe brain injuries.

中文翻译：

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ICU 中的隐秘意识。


对于患有急性严重脑损伤的危重患者，意识可能会在行为反应之前重新出现。对于床边行为检查无反应的患者，可以通过先进的神经技术（例如基于任务的功能性 MRI (fMRI) 和脑电图 (EEG)）来检测隐性意识（即认知运动分离）现象。在这篇叙述性评论中，我们总结了 ICU 隐性意识检测的最新科学进展。此外，我们考虑了在 ICU 中诊断隐性意识的预后和治疗意义，以及它为有关严重脑损伤患者继续生命维持治疗的讨论提供信息的潜力。