Are you Ernest Shackleton, the polar explorer? Refining the criteria for delirium and brain dysfunction in sepsis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-12

AUTHORS

Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande, Nicola Latronico

ABSTRACT

The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunctions in this consensus definition were identified as an organ-specific Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score ≥ 2 points. The quick SOFA (qSOFA) considers altered mentation indicating brain dysfunction when the Glasgow Coma Scale (GCS) score is ≤13 or ≤14. However, concern has been expressed that the revised criteria may lead to a failure in recognizing the signs of potentially lethal organ dysfunction and thus sepsis. Patients with delirium have a fluctuating course, and GCS can be normal or only slightly reduced at the time when signs of delirium are already present. We here report an illustrative case showing how an acute, initially unrecognized, urinary tract infection caused acute brain dysfunction with profound behavioral and cognitive dysfunction despite normal GCS, hence not meeting the criteria for sepsis. More... »

PAGES

23

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s40560-017-0218-z

DOI

http://dx.doi.org/10.1186/s40560-017-0218-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084253046

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28286656


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148 rdf:type schema:Organization
149 https://www.grid.ac/institutes/grid.452900.a schema:alternateName VA Tennessee Valley Healthcare System
150 schema:name Anesthesia Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, USA
151 Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine, Nashville, USA
152 rdf:type schema:Organization
153 https://www.grid.ac/institutes/grid.7637.5 schema:alternateName University of Brescia
154 schema:name Department of Anesthesiology, Critical Care Medicine and Emergency, Division of Neurocritical Care, Spedali Civili University Hospital, Piazzale Ospedali Civili, 1, 25123, Brescia, Italy
155 Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
156 rdf:type schema:Organization
 




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