title: Inflammation biomarkers and delirium in critically ill patients.
abstract: BACKGROUND
  Delirium is a common occurrence in critically ill patients and is associated with an increase in morbidity and mortality. Septic patients with delirium may differ from a general critically ill population. The aim of this investigation was to study the relationship between systemic inflammation and the development of delirium in septic and non-septic critically ill patients.
  
  
  METHODS
  We performed a prospective cohort study in a 20-bed mixed intensive care unit (ICU) including 78 (delirium = 31; non-delirium = 47) consecutive patients admitted for more than 24 hours. At enrollment, patients were allocated to septic or non-septic groups according to internationally agreed criteria. Delirium was diagnosed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) during the first 72 hours of ICU admission. Blood samples were collected within 12 hours of enrollment for determination of tumor necrosis factor (TNF)-α, soluble TNF Receptor (STNFR)-1 and -2, interleukin (IL)-1β, IL-6, IL-10 and adiponectin.
  
  
  RESULTS
  Out of all analyzed biomarkers, only STNFR1 (P = 0.003), STNFR2 (P = 0.005), adiponectin (P = 0.005) and IL-1β (P < 0.001) levels were higher in delirium patients. Adjusting for sepsis and sedation, these biomarkers were also independently associated with delirium occurrence. However, none of them were significant influenced by sepsis.
  
  
  CONCLUSIONS
  STNFR1, STNFR2, adiponectin and IL-1β were associated with delirium. Sepsis did not modify the relationship between the biomarkers and delirium occurrence.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Ritter
authors.forename: Cristiane D
authors.initials: CD
authors.lastname: Tomasi
authors.forename: Felipe
authors.initials: F
authors.lastname: Dal-Pizzol
authors.forename: Bernardo Bollen
authors.initials: BB
authors.lastname: Pinto
authors.forename: Alex
authors.initials: A
authors.lastname: Dyson
authors.forename: Aline S
authors.initials: AS
authors.lastname: de Miranda
authors.forename: Clarissa M
authors.initials: CM
authors.lastname: Comim
authors.forename: Márcio
authors.initials: M
authors.lastname: Soares
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Teixeira
authors.forename: João
authors.initials: J
authors.lastname: Quevedo
authors.forename: Mervyn
authors.initials: M
authors.lastname: Singer
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D016638:Critical Illness; D003693:Delirium / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000639:trends; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D015415:Biomarkers