ABSTRACT
Objective:
Acute brain dysfunction (delirium and coma) occurs frequently in critically ill patients and is associated with increased morbidity and mortality. Septic patients with brain dysfunction may differ from the general critically ill population. The aim of this investigation was to study the relationship between systemic inflammation markers and duration of acute brain dysfunction in sepsis patients.
Materials and Methods:
This study was a prospective, single-center, observational study of consecutive patients admitted with sepsis to the medical and surgical intensive care unit (ICU). Patients were assessed for coma and delirium with the Richmond Agitation-Sedation Scale and Confusion Assessment Method for the ICU. Plasma levels of procalcitonin and C-reactive protein (CRP) were measured on the day of ICU admission. Linear regression analysis was performed to determine the relationship between biomarkers and delirium/coma-free days.
Results:
A total of 79 sepsis patients (45 men, 34 women; 53.4±10.6 years) with acute brain dysfunction were enrolled. Higher procalcitonin levels were associated with fewer delirium/coma-free days (p=0.04, Correlation confidence: -0,343, R2= 0,12), whereas higher CRP levels were not correlated.
Conclusion:
In our present study, procalcitonin measured on admission to ICU predicted prolonged periods of acute brain dysfunction. Further investigations are needed on the inflammatory mechanisms of acute brain dysfunction in sepsis patients.
Keywords: Sepsis, brain dysfunction, inflammation, biomarker
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