Abstract
Investigations on the relationship between sepsis, brain dysfunction, and cerebral perfusion are methodologically very difficult to perform. It is important to interpret the results of such studies in view of our limited ability to diagnose and quantify brain dysfunction and to consider our limited understanding of the mechanisms that lead to or are associated with brain dysfunction in sepsis.
Highlights
Brain dysfunction is a serious complication of sepsis
The mechanisms leading to sepsis-associated delirium (SAD) are not completely understood and include reduced cerebral blood flow (CBF), disruption of the blood-brain barrier and cerebral oedema arising from the action of inflammatory mediators on the cerebrovascular endothelium, impaired astrocyte function, and neuronal degeneration [8]
A second question that is prompted by the work of Thees and colleagues is whether we should expect global CBF and CO2 reactivity to be disturbed in SAD
Summary
Brain dysfunction is a serious complication of sepsis. The severity of septic encephalopathy or sepsis-associated delirium (SAD) [6] is correlated with the global severity of sepsis and has been reported to be an independent predictor of death [7]. The mechanisms leading to SAD are not completely understood and include reduced CBF, disruption of the blood-brain barrier and cerebral oedema arising from the action of inflammatory mediators on the cerebrovascular endothelium, impaired astrocyte function, and neuronal degeneration [8].
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