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Lancet Respir Med. 2015 Jan;3(1):61-9. doi: 10.1016/S2213-2600(14)70246-2. Epub 2014 Nov 28.

Cognitive decline after sepsis.

Author information

1
Department of Intensive Care Medicine, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, Garches, France; University of Versailles, Montigny le Bretonneux, France. Electronic address: djillali.annane@rpc.aphp.fr.
2
Department of Intensive Care Medicine, Raymond Poincaré Hospital, Assistance Publique-Hôpitaux de Paris, Garches, France; University of Versailles, Montigny le Bretonneux, France.

Abstract

The modern era of sepsis management is characterised by a growing number of patients who survive in the short term and are discharged from hospital. Increasing evidence suggests that these survivors exhibit long-term neurological sequelae, particularly substantial declines in cognitive function. The exact prevalence and outcomes of these neuropsychological sequelae are unclear. The mechanisms by which sepsis induces cognitive dysfunction probably include vascular injuries and neuroinflammation that are mediated by systemic metabolism disorders and overwhelming inflammation, a disrupted blood-brain barrier, oxidative stress, and severe microglial activation, particularly within the limbic system. Interventions targeting the blood-brain barrier, glial activation, and oxidative stress have shown promise in prevention of cognitive dysfunction in various experimental models of sepsis. The next step should be to translate these favourable effects into positive clinical results.

PMID:
25434614
DOI:
10.1016/S2213-2600(14)70246-2
[Indexed for MEDLINE]

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