• Marco Menozzi, Juliette Gosse, Marta Talamonti, Eugenio Di Bernardini, Armin Quispe Cornejo, Thierry Gustot, Jacques Creteur, Lorenzo Peluso, and Fabio Silvio Taccone.
• Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
• J Crit Care. 2021 Apr 1; 62: 176-182.

PurposeTo evaluate whether pupillary abnormalities would correlate with the severity of encephalopathy in critically ill cirrhotic patients.MethodsIn this retrospective study, we enrolled adult cirrhotic patients admitted to the Intensive Care Unit undergoing automated pupillometry assessment within the first 72 h since ICU admission. Encephalopathy was assessed with West-Haven classification and Glasgow Coma Scale. Pupillometry-derived variables were also correlated with biological variables, including ammonium, renal function or inflammatory parameters, measured on the day of pupillary assessment.ResultsA total of 62 critically ill cirrhotic patients (Age 61 [52-68] years; 69% male) were included. Median GCS and West-Haven classification were 14 [11-15] and 1 [0-3], respectively. There was a significant although weak correlation between GCS and constriction velocity (CV; R2 = 0.1; p = 0.017). We observed significant differences in CV and DV values among different levels of West-Haven classification. When only patients with encephalopathy (n = 42) or severe HE (n = 18) were considered, a weak correlation between GCS and worst CV was observed. When patients receiving sedatives or opioids were excluded, no significant correlation between pupillometry and clinical variables was observed.ConclusionsPupillary function assessed by the automated pupillometry was poorly associated with encephalopathy scales in cirrhotic patients.Copyright © 2019. Published by Elsevier Inc.

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