Neurointensive care in sepsis

Focusing on sepsis-associated brain dysfunction

Abstract

The causes of acute brain dysfunction in sepsis can be divided into 1. narrowly-defined sepsis-associated acute brain dysfunction (SABD), 2. broadly-defined SABD, and 3. new neurological disease complications. Narrowly-defined SABD results from the direct effect of inflammatory mediators on the brain. Broadly-defined SABD is caused indirectly by sepsis-associated damage to organs other than the brain or by drugs. Narrowly-defined SABD is the most frequent sepsis-related organ disorder, affecting up to 70％ of patients with sepsis and often occurring before other organs are affected. The symptoms of narrowly-defined SABD are non-specific and a diagnosis by exclusion, taking into account the medical history, is important. 1. is mainly treated with sepsis, while 2. and 3. may require additional treatment or an early change in treatment.