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Level of consciousness

MedGen UID:
452295
•Concept ID:
C0234425
•
Finding
Synonyms: Level of Consciousness; LOC - Level of consciousness
SNOMED CT: LOC - Level of consciousness (6942003); Level of consciousness (6942003)

Definition

The level of awareness of an organism. [from NCI]

Professional guidelines

PubMed

Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce.
Menon K, Schlapbach LJ, Akech S, Argent A, Biban P, Carrol ED, Chiotos K, Jobayer Chisti M, Evans IVR, Inwald DP, Ishimine P, Kissoon N, Lodha R, Nadel S, Oliveira CF, Peters M, Sadeghirad B, Scott HF, de Souza DC, Tissieres P, Watson RS, Wiens MO, Wynn JL, Zimmerman JJ, Sorce LR; Pediatric Sepsis Definition Taskforce of the Society of Critical Care Medicine
Crit Care Med 2022 Jan 1;50(1):21-36. doi: 10.1097/CCM.0000000000005294. PMID: 34612847Free PMC Article
On the pathophysiology and treatment of akinetic mutism.
Arnts H, van Erp WS, Lavrijsen JCM, van Gaal S, Groenewegen HJ, van den Munckhof P
Neurosci Biobehav Rev 2020 May;112:270-278. Epub 2020 Feb 7 doi: 10.1016/j.neubiorev.2020.02.006. PMID: 32044373
EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure.
European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; Clinical practice guidelines panel, Wendon, J; Panel members, Cordoba J, Dhawan A, Larsen FS, Manns M, Samuel D, Simpson KJ, Yaron I; EASL Governing Board representative, Bernardi M
J Hepatol 2017 May;66(5):1047-1081. doi: 10.1016/j.jhep.2016.12.003. PMID: 28417882

Recent clinical studies

Etiology

Classification of Level of Consciousness in a Neurological ICU Using Physiological Data.
Gomez LA, Shen Q, Doyle K, Vrosgou A, Velazquez A, Megjhani M, Ghoshal S, Roh D, Agarwal S, Park S, Claassen J, Kleinberg S
Neurocrit Care 2023 Feb;38(1):118-128. Epub 2022 Sep 15 doi: 10.1007/s12028-022-01586-0. PMID: 36109448Free PMC Article
In-Hospital Depressed Level of Consciousness and Long-Term Functional Outcomes in ICU Survivors.
Mart MF, Thompson JL, Ely EW, Pandharipande PP, Patel MB, Wilson JE, Williams Roberson S, Birdrow CI, Raman R, Brummel NE
Crit Care Med 2022 Nov 1;50(11):1618-1627. Epub 2022 Aug 23 doi: 10.1097/CCM.0000000000005656. PMID: 36005816Free PMC Article
EEG Findings in Coronavirus Disease.
Pilato MS, Urban A, Alkawadri R, Barot NV, Castellano JF, Rajasekaran V, Bagić AI, Fong-Isariyawongse JS
J Clin Neurophysiol 2022 Feb 1;39(2):159-165. doi: 10.1097/WNP.0000000000000752. PMID: 32639251
Pituitary apoplexy.
Wichlińska-Lubińska M, Kozera G
Neurol Neurochir Pol 2019;53(6):413-420. Epub 2019 Nov 20 doi: 10.5603/PJNNS.a2019.0054. PMID: 31745969
Altered Mental Status and Delirium.
Wilber ST, Ondrejka JE
Emerg Med Clin North Am 2016 Aug;34(3):649-65. doi: 10.1016/j.emc.2016.04.012. PMID: 27475019

Diagnosis

Diagnosing Level of Consciousness: The Limits of the Glasgow Coma Scale Total Score.
Bodien YG, Barra A, Temkin NR, Barber J, Foreman B, Vassar M, Robertson C, Taylor SR, Markowitz AJ, Manley GT, Giacino JT, Edlow BL; TRACK-TBI Investigators
J Neurotrauma 2021 Dec;38(23):3295-3305. doi: 10.1089/neu.2021.0199. PMID: 34605668Free PMC Article
Pituitary apoplexy.
Wichlińska-Lubińska M, Kozera G
Neurol Neurochir Pol 2019;53(6):413-420. Epub 2019 Nov 20 doi: 10.5603/PJNNS.a2019.0054. PMID: 31745969
Migraine Variants in Children.
Rothner AD
Pediatr Ann 2018 Feb 1;47(2):e50-e54. doi: 10.3928/19382359-20180126-02. PMID: 29446794
The reliability of the Glasgow Coma Scale: a systematic review.
Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI
Intensive Care Med 2016 Jan;42(1):3-15. Epub 2015 Nov 12 doi: 10.1007/s00134-015-4124-3. PMID: 26564211
Bacterial meningitis.
Roos KL, van de Beek D
Handb Clin Neurol 2010;96:51-63. Epub 2010 Jan 19 doi: 10.1016/S0072-9752(09)96004-3. PMID: 20109674

Therapy

Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus.
Kapur J, Elm J, Chamberlain JM, Barsan W, Cloyd J, Lowenstein D, Shinnar S, Conwit R, Meinzer C, Cock H, Fountain N, Connor JT, Silbergleit R; NETT and PECARN Investigators
N Engl J Med 2019 Nov 28;381(22):2103-2113. doi: 10.1056/NEJMoa1905795. PMID: 31774955Free PMC Article
Pituitary apoplexy.
Wichlińska-Lubińska M, Kozera G
Neurol Neurochir Pol 2019;53(6):413-420. Epub 2019 Nov 20 doi: 10.5603/PJNNS.a2019.0054. PMID: 31745969
Therapeutic interventions in patients with prolonged disorders of consciousness.
Thibaut A, Schiff N, Giacino J, Laureys S, Gosseries O
Lancet Neurol 2019 Jun;18(6):600-614. Epub 2019 Apr 16 doi: 10.1016/S1474-4422(19)30031-6. PMID: 31003899
Potential benefits of zolpidem in disorders of consciousness.
Noormandi A, Shahrokhi M, Khalili H
Expert Rev Clin Pharmacol 2017 Sep;10(9):983-992. Epub 2017 Jul 10 doi: 10.1080/17512433.2017.1347502. PMID: 28649875
Bacterial meningitis.
Roos KL, van de Beek D
Handb Clin Neurol 2010;96:51-63. Epub 2010 Jan 19 doi: 10.1016/S0072-9752(09)96004-3. PMID: 20109674

Prognosis

The Current of Consciousness: Neural Correlates and Clinical Aspects.
Friedman G, Turk KW, Budson AE
Curr Neurol Neurosci Rep 2023 Jul;23(7):345-352. Epub 2023 Jun 12 doi: 10.1007/s11910-023-01276-0. PMID: 37303019Free PMC Article
The inter-relationship between delirium and dementia: the importance of delirium prevention.
Fong TG, Inouye SK
Nat Rev Neurol 2022 Oct;18(10):579-596. Epub 2022 Aug 26 doi: 10.1038/s41582-022-00698-7. PMID: 36028563Free PMC Article
Clinimetric study and review of the Reaction Level Scale.
Anestis DM, Monioudis PM, Foroglou NG, Tsonidis CA, Tsitsopoulos PP
Acta Neurol Scand 2022 Jun;145(6):706-720. Epub 2022 Mar 3 doi: 10.1111/ane.13604. PMID: 35243607
Diagnosing Level of Consciousness: The Limits of the Glasgow Coma Scale Total Score.
Bodien YG, Barra A, Temkin NR, Barber J, Foreman B, Vassar M, Robertson C, Taylor SR, Markowitz AJ, Manley GT, Giacino JT, Edlow BL; TRACK-TBI Investigators
J Neurotrauma 2021 Dec;38(23):3295-3305. doi: 10.1089/neu.2021.0199. PMID: 34605668Free PMC Article
Sepsis-associated encephalopathy: A review of literature.
Molnár L, Fülesdi B, Németh N, Molnár C
Neurol India 2018 Mar-Apr;66(2):352-361. doi: 10.4103/0028-3886.227299. PMID: 29547154

Clinical prediction guides

The Current of Consciousness: Neural Correlates and Clinical Aspects.
Friedman G, Turk KW, Budson AE
Curr Neurol Neurosci Rep 2023 Jul;23(7):345-352. Epub 2023 Jun 12 doi: 10.1007/s11910-023-01276-0. PMID: 37303019Free PMC Article
Diagnosing Level of Consciousness: The Limits of the Glasgow Coma Scale Total Score.
Bodien YG, Barra A, Temkin NR, Barber J, Foreman B, Vassar M, Robertson C, Taylor SR, Markowitz AJ, Manley GT, Giacino JT, Edlow BL; TRACK-TBI Investigators
J Neurotrauma 2021 Dec;38(23):3295-3305. doi: 10.1089/neu.2021.0199. PMID: 34605668Free PMC Article
Clinical Criteria for Tracheostomy Decannulation in Subjects with Acquired Brain Injury.
Enrichi C, Battel I, Zanetti C, Koch I, Ventura L, Palmer K, Meneghello F, Piccione F, Rossi S, Lazzeri M, Sommariva M, Turolla A
Respir Care 2017 Oct;62(10):1255-1263. Epub 2017 Jul 11 doi: 10.4187/respcare.05470. PMID: 28698267
The reliability of the Glasgow Coma Scale: a systematic review.
Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI
Intensive Care Med 2016 Jan;42(1):3-15. Epub 2015 Nov 12 doi: 10.1007/s00134-015-4124-3. PMID: 26564211
Intensive Care Delirium Screening Checklist: evaluation of a new screening tool.
Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y
Intensive Care Med 2001 May;27(5):859-64. doi: 10.1007/s001340100909. PMID: 11430542

Recent systematic reviews

Systematic review and meta-analysis of the correlation between bispectral index (BIS) and clinical sedation scales: Toward defining the role of BIS in critically ill patients.
Heavner MS, Gorman EF, Linn DD, Yeung SYA, Miano TA
Pharmacotherapy 2022 Aug;42(8):667-676. Epub 2022 Jun 30 doi: 10.1002/phar.2712. PMID: 35707961Free PMC Article
Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce.
Menon K, Schlapbach LJ, Akech S, Argent A, Biban P, Carrol ED, Chiotos K, Jobayer Chisti M, Evans IVR, Inwald DP, Ishimine P, Kissoon N, Lodha R, Nadel S, Oliveira CF, Peters M, Sadeghirad B, Scott HF, de Souza DC, Tissieres P, Watson RS, Wiens MO, Wynn JL, Zimmerman JJ, Sorce LR; Pediatric Sepsis Definition Taskforce of the Society of Critical Care Medicine
Crit Care Med 2022 Jan 1;50(1):21-36. doi: 10.1097/CCM.0000000000005294. PMID: 34612847Free PMC Article
Sepsis-associated encephalopathy: A review of literature.
Molnár L, Fülesdi B, Németh N, Molnár C
Neurol India 2018 Mar-Apr;66(2):352-361. doi: 10.4103/0028-3886.227299. PMID: 29547154
The reliability of the Glasgow Coma Scale: a systematic review.
Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI
Intensive Care Med 2016 Jan;42(1):3-15. Epub 2015 Nov 12 doi: 10.1007/s00134-015-4124-3. PMID: 26564211
Extracorporeal Treatment for Lithium Poisoning: Systematic Review and Recommendations from the EXTRIP Workgroup.
Decker BS, Goldfarb DS, Dargan PI, Friesen M, Gosselin S, Hoffman RS, Lavergne V, Nolin TD, Ghannoum M; EXTRIP Workgroup
Clin J Am Soc Nephrol 2015 May 7;10(5):875-87. Epub 2015 Jan 12 doi: 10.2215/CJN.10021014. PMID: 25583292Free PMC Article

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