====== Deep sedation ======

defined by a [[Richmond Agitation-Sedation Scale]] (RASS) (RASS) < -3

Deep [[sedation]] may hamper the detection of neurological [[deterioration]] in [[brain injury]].

Impaired [[brainstem reflex]]es within the first 24 h of deep sedation are associated with increased [[mortality]] in non-brain-injured patients.

Early (day 1) [[cough reflex]] abolition is an independent predictor of mortality in deeply sedated brain-injured patients. Abolished cough reflex likely reflects a [[brainstem]] dysfunction that might result from the combination of primary and secondary neuro-inflammatory cerebral insults revealed and/or worsened by sedation
((Kandelman S, Allary J, Porcher R, Righy C, Valdez CF, Rasulo F, Heming N, Moneger G, Azabou E, Savary G, Annane D, Chretien F, Latronico N, Bozza FA, Rohaut B, Sharshar T; Groupe d’Exploration Neurologique en Réanimation (GENeR). Early abolition of cough reflex predicts mortality in deeply sedated brain-injured patients. PeerJ. 2020 Nov 26;8:e10326. doi: 10.7717/peerj.10326. PMID: 33304651; PMCID: PMC7700733.)).