Absent cough reflex is associated with mortality in intensive care unit (ICU) patients requiring deep sedation, suggesting that lower brainstem dysfunction contributes to adverse outcomes. We conducted a multicenter observational cohort study to confirm this hypothesis by assessing the peak latency (PL) of the lower brainstem-generated P14 evoked potential (EP), which is slightly increased by sedatives.

We aimed to demonstrate that a P14-PL > 16 ms is independently associated with day-28 mortality.

Impaired neurological and neurophysiological lower brainstem responses are associated with mortality in deeply sedated patients.

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