Recent advances in the pathogenesis, diagnosis, and treatment of sepsis-associated encephalopathy

Brain-X Pub Date : 2024-06-30 DOI:10.1002/brx2.67
Rui Wang, Wanda Bi, Siyuan Huang, Qiuju Han, Jin Deng, Zhen Wang, Ling Zeng, Jianxin Jiang
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Abstract

Sepsis is a life-threatening organ dysfunction syndrome caused by the host's dysregulated response to infection. The leading causes of death in critically ill patients are sepsis-associated encephalopathy (SAE), respiratory dysfunction, circulatory dysfunction, and other multi-organ dysfunctions. SAE is among the most common serious complications of sepsis and is associated with a poor prognosis and long-term cognitive dysfunction. Its clinical manifestations vary, and there are still no unified diagnostic criteria. The incidence of SAE varies from 9% to 71% in critically ill patients due to therapeutic interventions such as sedation, mechanical ventilation, and muscle relaxants. Advances in medical technology have significantly increased the survival rate of patients with sepsis, but up to 21% now experience long-term sequelae or cognitive impairment. The lack of specific early diagnostic and treatment methods leads to increased SAE-associated mortality and complications in patients, which also impose heavy economic burdens. This article reviews the pathogenesis and diagnostic methods of SAE and progress in its treatment, aiming to reduce the mortality and hospitalization lengths of patients with SAE and improve their survival rate and quality of life through early detection, diagnosis, and effective treatment.

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脓毒症相关脑病的发病机制、诊断和治疗的最新进展
败血症是一种危及生命的器官功能障碍综合征,由宿主对感染的反应失调引起。危重病人的主要死因是败血症相关脑病(SAE)、呼吸功能障碍、循环功能障碍和其他多器官功能障碍。脓毒症相关脑病是脓毒症最常见的严重并发症之一,与预后不良和长期认知功能障碍有关。其临床表现各不相同,目前仍没有统一的诊断标准。由于镇静、机械通气和肌肉松弛剂等治疗干预措施,重症患者 SAE 的发生率从 9% 到 71% 不等。医疗技术的进步大大提高了脓毒症患者的存活率,但目前高达 21% 的患者会出现长期后遗症或认知障碍。由于缺乏特定的早期诊断和治疗方法,导致与 SAE 相关的患者死亡率和并发症增加,同时也造成了沉重的经济负担。本文回顾了 SAE 的发病机制、诊断方法和治疗进展,旨在通过早期发现、诊断和有效治疗,降低 SAE 患者的死亡率和住院时间,提高其生存率和生活质量。
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