Chiara Robba1,2, Ilaria Alice Crippa2,3, Fabio Silvio Taccone4,5. 1. Anaesthesia and Intensive Care, IRCCS for Oncology, San Martino Policlinico Hospital, Genova, Italy. 2. Department of Surgical Sciences and Integrated Diagnostic, University of Genova, Genova, Italy. 3. Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium. 4. Department of Surgical Sciences and Integrated Diagnostic, University of Genova, Genova, Italy. ftaccone@ulb.ac.be. 5. Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium. ftaccone@ulb.ac.be.
Abstract
PURPOSE OF THE REVIEW: To discuss the diagnostic approach to patients with septic encephalopathy as well as the need for specific neuro-monitoring and the perspectives on future therapeutic approaches in this setting. RECENT FINDINGS: Most of data-concern experimental studies evaluating the pathophysiology of septic encephalopathy. A combination of neurodegenerative pathways with neurovascular injury is the cornerstone for the development of such complication and the long-term neurological sequelae among survivors. Septic encephalopathy is a common complication in septic patients. Clinical presentation may range from mild confusion and disorientation to convulsions and deep coma. The diagnosis of septic encephalopathy is made difficult by the lack of any specific clinical and non-clinical feature, in particular among sedated patients in whom neurological examination is unreliable. In spite of the high mortality rate associated with this condition, there is no prophylactic or targeted therapy to reduce or minimize brain damage in septic patients and clinical management is limited to the treatment of the underlying infection.
PURPOSE OF THE REVIEW: To discuss the diagnostic approach to patients with septic encephalopathy as well as the need for specific neuro-monitoring and the perspectives on future therapeutic approaches in this setting. RECENT FINDINGS: Most of data-concern experimental studies evaluating the pathophysiology of septic encephalopathy. A combination of neurodegenerative pathways with neurovascular injury is the cornerstone for the development of such complication and the long-term neurological sequelae among survivors. Septic encephalopathy is a common complication in septicpatients. Clinical presentation may range from mild confusion and disorientation to convulsions and deep coma. The diagnosis of septic encephalopathy is made difficult by the lack of any specific clinical and non-clinical feature, in particular among sedated patients in whom neurological examination is unreliable. In spite of the high mortality rate associated with this condition, there is no prophylactic or targeted therapy to reduce or minimize brain damage in septicpatients and clinical management is limited to the treatment of the underlying infection.
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