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Sepsis Associated Delirium

1
Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James’s Hospital, St. James Street, Dublin 8, Dublin, D08 NHY1, Ireland
2
Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar de Lisboa Ocidental, 1449-005 Lisbon, Portugal
3
NOVA Medical School, CHRC, New University of Lisbon, 1099-085 Lisbon, Portugal
4
Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, 5000 Odense, Denmark
5
Hospital Clinic, IDIBAPS, Universidad de Barcelona, Ciberes, 08036 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Medicina 2020, 56(5), 240; https://doi.org/10.3390/medicina56050240
Received: 16 April 2020 / Revised: 13 May 2020 / Accepted: 14 May 2020 / Published: 18 May 2020
(This article belongs to the Special Issue Delirium in Critically Ill Patients)
Sepsis is a potentially life-threatening condition caused by a systemic dysregulated host response to infection. The brain is particularly susceptible to the effects of sepsis with clinical manifestations ranging from mild confusion to a deep comatose state. Sepsis-associated delirium (SAD) is a cerebral manifestation commonly occurring in patients with sepsis and is thought to occur due to a combination of neuroinflammation and disturbances in cerebral perfusion, the blood brain barrier (BBB) and neurotransmission. The neurological impairment associated with SAD can persist for months or even longer, after the initial septic episode has subsided which may impair the rehabilitation potential of sepsis survivors. Early identification and treatment of the underlying sepsis is key in the management of SAD as once present it can be difficult to control. Through the regular use of validated screening tools for delirium, cases of SAD can be identified early; this allows potentially aggravating factors to be addressed promptly. The usefulness of biomarkers, neuroimaging and electroencephalopathy (EEG) in the diagnosis of SAD remains controversial. The Society of Critical Care Medicine (SCCM) guidelines advise against the use of medications to treat delirium unless distressing symptoms are present or it is hindering the patient’s ability to wean from organ support. View Full-Text
Keywords: sepsis; delirium; ICU; dexmedetomidine sepsis; delirium; ICU; dexmedetomidine
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Atterton, B.; Paulino, M.C.; Povoa, P.; Martin-Loeches, I. Sepsis Associated Delirium. Medicina 2020, 56, 240.

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