Sepsis-associated delirium.
OBJECTIVE
Sepsis-associated delirium is a common and poorly understood neurological complication of sepsis. This review provides an update of the diagnostic criteria and treatment strategies and the current knowledge about the mechanisms involved in sepsis associated brain dysfunction.


METHODS
Articles published between 1981 and 2006 were identified through a Medline search for "encephalopathy" and "sepsis" and by hand searching of articles cited in the identified publications. The immune response to sepsis results in multiorgan failure including brain dysfunction.


CONCLUSIONS
The potential mechanisms for sepsis-associated delirium include vascular damage, endothelial activation, breakdown of the blood-brain barrier, metabolic disorders, brain inflammation and apoptosis. On the other hand, there is evidence for distinct neuroprotective factors, such as anti-inflammatory mediators and glial cell activity.


CONCLUSIONS
The diagnosis of sepsis-associated delirium relies mainly on clinical and electrophysiological criteria, and its treatment is entirely based on general management of sepsis.
Ebersoldt
Marion
M
Université de Versailles Saint Quentin, Service de Réanimation Médicale, Hôpital Raymond Poincaré (AP-HP), 104 Boulevard Raymond Poincaré, 92380 Garches, France.
Sharshar
Tarek
T
Annane
Djillali
D
D003693:Delirium / Q000209:etiology*; D005602:France; D006801:Humans; D018805:Sepsis / Q000150:complications / Q000523:psychology*