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Review
. 2020 Aug 12;17(16):5852.
doi: 10.3390/ijerph17165852.

Sepsis-Associated Brain Dysfunction: A Review of Current Literature

Piotr F Czempik  1 , Michał P Pluta  2   3 , Łukasz J Krzych  1
Affiliations
Review

Sepsis-Associated Brain Dysfunction: A Review of Current Literature

Piotr F Czempik et al. Int J Environ Res Public Health. .

Abstract

Sepsis-associated brain dysfunction (SABD) may be the most common type of encephalopathy in critically ill patients. SABD develops in up to 70% of septic patients and represents the most frequent organ insufficiency associated with sepsis. It presents with a plethora of acute neurological features and may have several serious long-term psychiatric consequences. SABD might cause various pathological changes in the brain through numerous mechanisms. Clinical neurological examination is the basic screening method for SABD, although it may be challenging in subjects receiving with opioids and sedative agents. As electrographic seizures and periodic discharges might be present in 20% of septic patients, screening with electroencephalography (EEG) might be useful. Several imaging techniques have been suggested for non-invasive assessment of structure and function of the brain in SABD patients; however, their usefulness is rather limited. Although several experimental therapies have been postulated, at the moment, no specific treatment exists. Clinicians should focus on preventive measures and optimal management of sepsis. This review discusses epidemiology, clinical presentation, pathology, pathophysiology, diagnosis, management, and prevention of SABD.

Keywords: diagnosis; epidemiology; management; pathophysiology; prevention; sepsis-associated brain dysfunction; sepsis-associated encephalopathy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proposed pathophysiologic changes in sepsis-associated brain dysfunction.
See this image and copyright information in PMC

References

    1. Rhodes A., Evans L.E., Alhazzani W., Levy M.M., Antonelli M., Ferrer R., Kumar A., Sevransky J.E., Sprung C.L., Nunnally M.E., et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Crit. Care Med. 2017;43:304–377. doi: 10.1007/s00134-017-4683-6. - DOI - PubMed
    1. Singer M., Deutschman C.S., Seymour C.W., Shankar-Hari M., Annane D., Bauer M., Bellomo R., Bernard G.R., Chiche J.-D., Coopersmith C.M., et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315:801–810. doi: 10.1001/jama.2016.0287. - DOI - PMC - PubMed
    1. Salluh J.I., Soares M., Teles J.M., Ceraso D., Raimondi N., Nava V.S., Blasquez P., Ugarte S., Ibanez-Guzman C., Centeno J.V., et al. Delirium epidemiology in critical care (DECCA): An international study. Crit. Care. 2010;14:R210. doi: 10.1186/cc9333. - DOI - PMC - PubMed
    1. Gofton T.E., Young G.B. Sepsis-associated encephalopathy. Nat. Rev. Neurol. 2012;8:557–566. doi: 10.1038/nrneurol.2012.183. - DOI - PubMed
    1. Bolton C.F., Young G.B., Zochodne D.W. The neurological complications of sepsis. Ann. Neurol. 1993;33:94–100. doi: 10.1002/ana.410330115. - DOI - PubMed