• Medicina · Sep 2020

    Review

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

    • Wojciech Dabrowski, Dorota Siwicka-Gieroba, Malgorzata Gasinska-Blotniak, Sami Zaid, Maja Jezierska, Cezary Pakulski, Shawniqua Williams Roberson, Wesley Ely Eugene E Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, 1211, Nashville, TN 37232, USA. , and Katarzyna Kotfis.
    • Department of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, Poland.
    • Medicina (Kaunas). 2020 Sep 13; 56 (9).

    AbstractDelirium, 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.

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