A committee has developed a guideline on prolonged disorders of consciousness. Caution in prognostication is advocated because patients who have been unconscious or barely conscious for a long time might improve. The new guideline voices concern about persistent vegetative state as a clinical diagnosis but also rejects several unsupported therapies.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Giacino, J. T. et al. Practice guideline update recommendations summary: disorders of consciousness. Neurology 91, 450–460 (2018).
Wade, D. T. How often is the diagnosis of the permanent vegetative state incorrect? A review of the evidence. Eur. J. Neurol. 25, 619–625 (2018).
Wijdicks, E. F. Being comatose: why definition matters. Lancet Neurol. 11, 657–658 (2012).
Wijdicks, E. F. The Comatose Patient 2nd edn (Oxford Univ. Press, 2014).
Bosslet, G. T. et al. An official ATS/AACN/ACCP/ESICM/SCCM policy statement: responding to requests for potentially inappropriate treatments in intensive care units. Am. J. Respir. Crit. Care Med. 191, 1318–1330 (2015).
Souter, M. J. et al. Recommendations for the critical care management of devastating brain injury: prognostication, psychosocial, and ethical management. Neurocrit. Care 23, 4–13 (2015).
Fins, J. J. Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness (Cambridge Univ. Press, 2015).
Annas, G. J. Worst Case Bioethics: Death, Disaster, and Public Health (Oxford Univ. Press, 2011).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The author declares no competing interests.
Rights and permissions
About this article
Cite this article
Wijdicks, E.F.M. Who improves from coma, how do they improve, and then what?. Nat Rev Neurol 14, 694–696 (2018). https://doi.org/10.1038/s41582-018-0084-x
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41582-018-0084-x