Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status.

72 patients were included in the initial group and 72 in a subsequent validation study.

Neurologic responses were independent of sedative dose.

22 patients in the development cohort and 21 (29%) in the validation group died within 28 days of inclusion.

Adjusted for Simplified Acute Physiology Score II score, absent cough reflex was independently associated with 28-day mortality in the development and validation groups.

Mechanically ventilated intensive care unit patients sedated with midazolam.

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