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Báo cáo y học: "Brain dysfunction in sepsis: what can we learn from cerebral perfusion studies"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Brain dysfunction in sepsis: what can we learn from cerebral perfusion studies? | Available online http ccforum.eom content 12 1 107 Commentary Brain dysfunction in sepsis what can we learn from cerebral perfusion studies Luzius A Steiner Department of Anaesthesia University Hospital Basel Spitalstrasse 21 CH-4031 Basel Switzerland Corresponding author Luzius A Steiner lsteiner@uhbs.ch Published 18 January 2008 This article is online at http ccforum.com content 12 1 107 2008 BioMed Central Ltd Critical Care 2008 12 107 doi 10.1186 cc6217 See related research by Thees et al. http ccforum.com content 11 6 R123 Abstract Investigations on the relationship between sepsis brain dysfunction and cerebral perfusion are methodologically very difficult to perform. It is important to interpret the results of such studies in view of our limited ability to diagnose and quantify brain dysfunction and to consider our limited understanding of the mechanisms that lead to or are associated with brain dysfunction in sepsis. Thees and colleagues 1 performed an interesting study in a group of patients who are difficult to investigate. They measured cerebral haemodynamics and CO2 reactivity in 10 mechanically ventilated patients with sepsis syndrome. They report normal global cerebral blood flow CBF and also normal responses to a decrease in the arterial partial pressure of CO2 assessed as critical closing pressure and CO2 reactivity. CO2 reactivity has previously been investigated in similar groups of patients but with inconsistent results. Bowton and colleagues 2 and Matta and Stow 3 found normal values Terborg and colleagues 4 found impaired CO2 reactivity and Bowie and colleagues 5 reported values ranging from reduced to exaggerated CO2 responses. Brain dysfunction is a serious complication of sepsis. The severity of septic encephalopathy or sepsis-associated delirium SAD 6 is correlated with the global severity of sepsis and has been reported to be an independent predictor of death 7 . The mechanisms leading to SAD are not completely understood and include .