Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients.
Wojciech DąbrowskiDorota Siwicka-GierobaMalgorzata Gasinska-BlotniakSami ZaidMaja JezierskaCezary PakulskiShawniqua Williams RobersonEugene Wesley ElyKatarzyna KotfisPublished in: Medicina (Kaunas, Lithuania) (2020)
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.
Keyphrases
- cardiac surgery
- brain injury
- hip fracture
- liver failure
- subarachnoid hemorrhage
- traumatic brain injury
- cerebral ischemia
- healthcare
- spinal cord injury
- respiratory failure
- lipopolysaccharide induced
- emergency department
- type diabetes
- aortic dissection
- coronary artery disease
- cardiovascular disease
- cognitive impairment
- inflammatory response
- acute respiratory distress syndrome