Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2020 Sep 16

PMID 32933176

Citations 7

Authors

Wojciech Dabrowski

Dorota Siwicka-Gieroba

Malgorzata Gasinska-Blotniak

Sami Zaid

Maja Jezierska

Cezary Pakulski

Shawniqua Williams Roberson

Eugene Wesley Ely

Katarzyna Kotfis

Affiliations

Soon will be listed here.

Abstract

Delirium, an acute alteration in mental status characterized by confusion, inattention and a fluctuating level of arousal, is a common problem in critically ill patients. Delirium prolongs hospital stay and is associated with higher mortality. The pathophysiology of delirium has not been fully elucidated. Neuroinflammation and neurotransmitter imbalance seem to be the most important factors for delirium development. In this review, we present the most important pathomechanisms of delirium in critically ill patients, such as neuroinflammation, neurotransmitter imbalance, hypoxia and hyperoxia, tryptophan pathway disorders, and gut microbiota imbalance. A thorough understanding of delirium pathomechanisms is essential for effective prevention and treatment of this underestimated pathology in critically ill patients.

Citing Articles

The possible role of gut microbiota dysbiosis in the pathophysiology of delirium in older persons.

Ticinesi A, Parise A, Nouvenne A, Cerundolo N, Prati B, Meschi T Microbiome Res Rep. 2023; 2(3):19.

PMID: 38046817 PMC: 10688815. DOI: 10.20517/mrr.2023.15.

Potential Usefulness of Blood Urea Nitrogen to Creatinine Ratio in the Prediction and Early Detection of Delirium Motor Subtype in the Intensive Care Unit.

Park W, Kim H, Park J, Kim H, Cho J, Oh J J Clin Med. 2022; 11(17).

PMID: 36078999 PMC: 9457387. DOI: 10.3390/jcm11175073.

Intensive care unit delirium in patients with severe COVID-19: A prospective observational cohort study.

Smith R, Lachner C, Singh V, Cartin-Ceba R Int J Crit Illn Inj Sci. 2022; 12(2):61-69.

PMID: 35845128 PMC: 9285129. DOI: 10.4103/ijciis.ijciis_93_21.

Cytokine profiles in intensive care unit delirium.

Smith R, Lachner C, Singh V, Trivedi S, Khatua B, Cartin-Ceba R Acute Crit Care. 2022; 37(3):415-428.

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Efficacy of Triple Viable Enteric-Coated Capsules Combined with Enteral Nutrition on Patients with Chronic Critical Illness and Influence on Immune and Coagulation Function.

Wang W, Zhang H, Huang W Evid Based Complement Alternat Med. 2021; 2021:3718255.

PMID: 34691213 PMC: 8536439. DOI: 10.1155/2021/3718255.

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