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

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 eluci...

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Detalles Bibliográficos
Autores principales: Dabrowski, Wojciech, Siwicka-Gieroba, Dorota, Gasinska-Blotniak, Malgorzata, Zaid, Sami, Jezierska, Maja, Pakulski, Cezary, Williams Roberson, Shawniqua, Wesley Ely, Eugene, Kotfis, Katarzyna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560040/
https://www.ncbi.nlm.nih.gov/pubmed/32933176
http://dx.doi.org/10.3390/medicina56090469
Descripción
Sumario: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.