Cerebral Perfusion in Sepsis-Associated Delirium
Author Information
Author(s): David Pfister, Martin Siegemund, Salome Dell-Kuster, Peter Smielewski, Stephan Rüegg, Stephan P. Strebel, Stephan C. Marsch, Hans Pargger, Luzius A. Steiner
Primary Institution: University Hospital Basel
Hypothesis
Cerebral perfusion and selected serum markers of inflammation and delirium differ in septic patients with and without sepsis-associated delirium.
Conclusion
Cerebral perfusion did not differ between patients with and without sepsis-associated delirium, but autoregulation was impaired in those with delirium.
Supporting Evidence
- Cerebral perfusion assessed with transcranial Doppler and near-infrared spectroscopy did not differ between patients with and without sepsis-associated delirium.
- The state of cerebrovascular autoregulation differed significantly between the two groups.
- Higher values of C-reactive protein were significantly correlated with increasingly disturbed autoregulation.
- Elevated S-100β and cortisol were associated with sepsis-associated delirium.
Takeaway
Doctors studied patients with sepsis to see if their brain blood flow was different if they had confusion. They found that while the blood flow was similar, the way their blood vessels reacted was not.
Methodology
The study involved monitoring 23 adult patients with sepsis for cerebral perfusion and serum markers after stabilisation in the ICU.
Potential Biases
Potential bias due to the observational nature of the study and variability in patient management.
Limitations
The small sample size and inability to control for certain variables like PaCO2 and temperature.
Participant Demographics
Median age was 74.5 years, with 38% female participants.
Statistical Information
P-Value
P = 0.015 for autoregulation differences, P = 0.008 for CRP levels.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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