Septic-Associated Encephalopathy: a Comprehensive Review

GHU Paris Psychiatrie et Neuroscience. Neurointensive Care and Neuroanesthesia Department. Paris, France / Hôpital Européen Georges Pompidou. Medical Intensive Care Unit. Paris, France / Université de Paris. Paris, France.
GHU Paris Psychiatrie et Neuroscience. Neurointensive Care and Neuroanesthesia Department. Paris, France / Instituto Estadual do Cérebro Paul Niemeyer. Rio de Janeiro, RJ, Brasil.
GHU Paris Psychiatrie et Neuroscience. Neurointensive Care and Neuroanesthesia Department. Paris, France / Hôpital Européen Georges Pompidou. Medical Intensive Care Unit. Paris, France / Université de Paris. Paris, France.
Université de Paris. Paris, France / Centre Hospitalier Universitaire Cochin. Médecine Intensive et Réanimation. Paris, France.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.
GHU Paris Psychiatrie et Neuroscience. Neurointensive Care and Neuroanesthesia Department. Paris, France / Université de Paris. Paris, France.

Abstract

Septic-associated encephalopathy (SAE) is a key manifestation of sepsis, ranging from delirium to coma and occurring in up to 70% of patients admitted to the ICU. SAE is associated with higher ICU and hospital mortality, and also with poorer long-term outcomes, including cognitive and functional outcomes. The pathophysiology of SAE is complex, and it may involve neurotransmitter dysfunction, inflammatory and ischemic lesions to the brain, microglial activation, and blood-brain barrier dysfunction. Delirium (which is included in the SAE spectrum) is mostly diagnosed with validated scales in the ICU population. There is no established treatment for SAE; benzodiazepines should generally be avoided in this setting. Nonpharmacological prevention and management is key for treating SAE; it includes avoiding oversedation (mainly with benzodiazepines), early mobilization, and sleep promotion.

Keywords

Sepsis
Blood–brain barrier
Microglia
Neuroanatomy
Neuroinflammation
Sepsis-associated encephalopathy

Publisher

Springer

Citation

MAZERAUD, Aurélien et al. “Septic-Associated Encephalopathy: a Comprehensive Review. Neurotherapeutics, v. 17, n. 2, p. 392-403, 2020.

DOI

10.1007/s13311-020-00862-1

ISSN

1933-7213

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/42365

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Copyright

Restricted access

Embargo date

2051-01-01

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