About this trial
The goal of this observational study is to determine whether the clinical response to olfactory stimulation (known as the "sniff" response) can help predict 3-month neurological outcomes in ICU patients with persistent disorders of consciousness after sedation withdrawal, regardless of the reason for admission or the initial severity.
The main questions this study aims to answer are:
* Can the "sniff" response to olfactory stimulation predict neurological outcomes at 3 months? * Is this response a better prognostic indicator than commonly used neurophysiological tests? Researchers will compare the results obtained from olfactory stimulation with those from somatosensory and auditory stimulations to determine whether the olfactory method provides additional or superior prognostic value.
Participants will receive additional olfactory stimuli as part of the neurophysiological evaluation for prognostic purposes and be followed up at 3 months for clinical, neurological, and functional evaluation
Eligibility criteria
Qualifiers
Admission to neuro-intensive care unit (neuro-ICU)
Age ≥ 18 years
Patients with persistent disorders of consciousness defined by an abnormal CRS-R score (<16) at 72 hours after sedation withdrawal and spontaneous ventilation
Consent obtained from legal representatives or activation of emergency waiver
Disqualifiers
Pregnancy
Brain death
Pre-existing ENT or olfactory bulb pathologies that may affect olfactory functions
Acute or chronic peripheral neurological diseases that may alter evoked potentials
Trial design
Treatments tested in this trial
- Olfactory stimulation