title: Sepsis-associated delirium.
abstract: 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.
authors.affiliation: Université de Versailles Saint Quentin, Service de Réanimation Médicale, Hôpital Raymond Poincaré (AP-HP), 104 Boulevard Raymond Poincaré, 92380 Garches, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Ebersoldt
authors.forename: Tarek
authors.initials: T
authors.lastname: Sharshar
authors.forename: Djillali
authors.initials: D
authors.lastname: Annane
mesh_terms: D003693:Delirium / Q000209:etiology*; D005602:France; D006801:Humans; D018805:Sepsis / Q000150:complications / Q000523:psychology*