Metabolic encephalopathies in the critical care unit.
OBJECTIVE
This article summarizes the most common etiologies and approaches to management of metabolic encephalopathy.


RESULTS
Metabolic encephalopathy is a frequent occurrence in the intensive care unit setting. Common etiologies include hepatic failure, renal failure, sepsis, electrolyte disarray, and Wernicke encephalopathy. Current treatment paradigms typically focus on supportive care and management of the underlying etiology. Directed therapies that target neurochemical and neurotransmitter pathways that mediate encephalopathy are not currently available and represent an important area for future research. Although commonly thought of as reversible neurologic insults, delirium and encephalopathy have been associated with increased mortality, prolonged length of stay and hospital complications, and worse long-term cognitive and functional outcomes.


CONCLUSIONS
Recognition and treatment of encephalopathy is critical to improving outcomes in critically ill patients.
Mount Sinai School of Medicine, Department of Neurology, One Gustave Levy Place, Box 1136, New York, NY 10029, USA. Jennifer.Frontera@mountsinai.org
Jennifer A
JA
Frontera
D001925:Brain Damage, Chronic / Q000209:etiology / Q000517:prevention & control; D001928:Brain Diseases, Metabolic / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D003693:Delirium / Q000209:etiology; D004700:Endocrine System Diseases / Q000150:complications; D006501:Hepatic Encephalopathy / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D008020:Life Support Care; D044342:Malnutrition / Q000150:complications; D008661:Metabolism, Inborn Errors / Q000150:complications; D059906:Neuroimaging; D009460:Neurologic Examination; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D017582:Renal Replacement Therapy; D018805:Sepsis / Q000150:complications / Q000188:drug therapy; D012720:Severity of Illness Index; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000150:complications / Q000628:therapy