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...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-09-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1010-660X/56/9/469 |
| _version_ | 1797721209176064000 |
|---|---|
| author | Wojciech Dabrowski Dorota Siwicka-Gieroba Malgorzata Gasinska-Blotniak Sami Zaid Maja Jezierska Cezary Pakulski Shawniqua Williams Roberson Eugene Wesley Ely Katarzyna Kotfis |
| author_facet | Wojciech Dabrowski Dorota Siwicka-Gieroba Malgorzata Gasinska-Blotniak Sami Zaid Maja Jezierska Cezary Pakulski Shawniqua Williams Roberson Eugene Wesley Ely Katarzyna Kotfis |
| author_sort | Wojciech Dabrowski |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T09:31:21Z |
| format | Article |
| id | doaj.art-9bedf2fca18e4900a1d91437f2cb2d2c |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T09:31:21Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-9bedf2fca18e4900a1d91437f2cb2d2c2023-09-02T13:54:18ZengMDPI AGMedicina1010-660X2020-09-015646946910.3390/medicina56090469Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill PatientsWojciech Dabrowski0Dorota Siwicka-Gieroba1Malgorzata Gasinska-Blotniak2Sami Zaid3Maja Jezierska4Cezary Pakulski5Shawniqua Williams Roberson6Eugene Wesley Ely7Katarzyna Kotfis8Department of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, PolandDepartment of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, PolandDepartment of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, PolandDepartment of Anaesthesia, Al-Emadi-Hospital Doha, P.O. Box 5804 Doha, QatarDepartment of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, PolandDepartment of Anaesthesiology, Intensive Therapy and Emergency Medicine, Pomeranian Medical University in Szczecin, 71-252 Szczecin, PolandCritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, 1211, Nashville, TN 37232, USACritical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, 1211, Nashville, TN 37232, USADepartment of Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, 70-111 Szczecin, PolandDelirium, 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.https://www.mdpi.com/1010-660X/56/9/469deliriumcritical illnesshypoxiahyperoxianeuroinflammationneurotransmitter agents |
| spellingShingle | Wojciech Dabrowski Dorota Siwicka-Gieroba Malgorzata Gasinska-Blotniak Sami Zaid Maja Jezierska Cezary Pakulski Shawniqua Williams Roberson Eugene Wesley Ely Katarzyna Kotfis Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients Medicina delirium critical illness hypoxia hyperoxia neuroinflammation neurotransmitter agents |
| title | Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients |
| title_full | Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients |
| title_fullStr | Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients |
| title_full_unstemmed | Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients |
| title_short | Pathomechanisms of Non-Traumatic Acute Brain Injury in Critically Ill Patients |
| title_sort | pathomechanisms of non traumatic acute brain injury in critically ill patients |
| topic | delirium critical illness hypoxia hyperoxia neuroinflammation neurotransmitter agents |
| url | https://www.mdpi.com/1010-660X/56/9/469 |
| work_keys_str_mv | AT wojciechdabrowski pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT dorotasiwickagieroba pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT malgorzatagasinskablotniak pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT samizaid pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT majajezierska pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT cezarypakulski pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT shawniquawilliamsroberson pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT eugenewesleyely pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients AT katarzynakotfis pathomechanismsofnontraumaticacutebraininjuryincriticallyillpatients |