Occurrence of nervous system involvement in SIRS

Marchiori, Paulo Eurípedes; Lino, Angelina Maria Martins; Hirata, Mário H.; Carvalho, Nise B.; Brotto, Mario Wilson Iervolino; Scaff, Milberto

doi:10.1016/j.jns.2006.08.015

Cited by 9 publications

(8 citation statements)

References 43 publications

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“…The methodological characteristics of the studies are shown in Table 1 . Five studies were retrospective [ 24 , 27 , 28 , 30 , 32 ], eight prospective [ 16 - 18 , 21 , 25 , 26 , 29 , 31 ] and the study design was not mentioned in the four other studies [ 19 , 20 , 22 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…The inclusion criteria were different in the various studies. Eleven studies used EEG, including eight with intermittent EEG [ 18 , 20 - 23 , 27 , 28 , 31 ] and three with continuous EEG monitoring [ 24 , 30 , 32 ]. Quantitative EEG was performed in three studies [ 16 , 19 , 26 ], including one study where the bispectral index (BIS) was monitored [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

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Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review

et al. 2014

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IntroductionSeveral studies have reported the presence of electroencephalography (EEG) abnormalities or altered evoked potentials (EPs) during sepsis. However, the role of these tests in the diagnosis and prognostic assessment of sepsis-associated encephalopathy remains unclear.MethodsWe performed a systematic search for studies evaluating EEG and/or EPs in adult (≥18 years) patients with sepsis-associated encephalopathy. The following outcomes were extracted: a) incidence of EEG/EP abnormalities; b) diagnosis of sepsis-associated delirium or encephalopathy with EEG/EP; c) outcome.ResultsAmong 1976 citations, 17 articles met the inclusion criteria. The incidence of EEG abnormalities during sepsis ranged from 12% to 100% for background abnormality and 6% to 12% for presence of triphasic waves. Two studies found that epileptiform discharges and electrographic seizures were more common in critically ill patients with than without sepsis. In one study, EEG background abnormalities were related to the presence and the severity of encephalopathy. Background slowing or suppression and the presence of triphasic waves were also associated with higher mortality. A few studies demonstrated that quantitative EEG analysis and EP could show significant differences in patients with sepsis compared to controls but their association with encephalopathy and outcome was not evaluated.ConclusionsAbnormalities in EEG and EPs are present in the majority of septic patients. There is some evidence to support EEG use in the detection and prognostication of sepsis-associated encephalopathy, but further clinical investigation is needed to confirm this suggestion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review

et al. 2014

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“…The use of a hind-limb (an organ remote from the brain) IR model which induced a robust microglial activation and proapoptotic changes in brain suggests that circulating cytokines mediate cerebral injury during reperfusion. Cytokines in SIRS have been proposed as the cause for encephalopathy in critically ill adult patients with sepsis [13]. In neonates, maternal infection and fetal inflammatory response have been associated with white-matter injury and cerebral palsy [14].…”

Section: Discussionmentioning

confidence: 99%

Systemic Inflammation following Hind-Limb Ischemia-Reperfusion Affects Brain in Neonatal Mice

et al. 2008

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Antenatal and postnatal infection and inflammation are associated with neurological injury in neonates. However, no direct role for systemic inflammation in mediating neurodamage has been shown. The study was aimed to determine whether systemic inflammation following ischemia-reperfusion (IR) of an organ remotely located from the brain results in cerebral injury. Neonatal mice were subjected to 2 h of hind-limb IR. At 48 h of reperfusion, brains were examined for activation of microglia and caspase-3. Lungs were assessed for pulmonary edema and granulocyte infiltration. The levels of circulating inflammatory mediators were measured at 24 h of reperfusion. In a separate cohort of mice, changes in the cerebral and hind-limb blood flow were measured. All data were compared to that in sham mice. Compared to shams the degree of pulmonary edema in IR mice was 33% (p = 0.04) greater. This was associated with significantly (p = 0.0006) greater granulocytic infiltration and a markedly increased level of circulating cytokines. The brains of these same mice exhibited significantly (p = 0.02) greater numbers of caspase-3-immunopositive cells and activation of microglia compared to sham mice. These data indicate that systemic inflammation following IR in the organ remote from the brain can induce neuroinflammation and cerebral proapoptotic changes.

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“…[31] This pattern of neuropathy has also been observed in humans with severe inflammatory response syndrome associated with a wide variety of conditions from cardio-vascular surgery to chronic respiratory diseases. [32]…”

Section: Discussionmentioning

confidence: 99%

Assessment of Recovery From Burn-Related Neuropathy by Electrodiagnostic Testing

Gabriel

Kowalske

Holavanahalli

2009

Journal of Burn Care & Research

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The purpose of this study was to investigate the recovery of burn related neuropathies by electrodiagnostic testing. Burn patients who presented to an American Burn Association verified burn center were interviewed and examined for clinical evidence of peripheral neuropathies by a physiatrist. Patients whom consented to participate were tested for electrodiagnostic evidence of peripheral neuropathy. Repeated studies were performed to assess for evidence of recovery.A total of 370 patients were screened. 36 (9.73%) patients had clinical evidence of neuropathy. Eighteen male patients with a mean total body surface area burn of 42% had nerve conduction studies performed. Etiologies of the injuries included 8 flame, 8 electrical and 3 others. Seventy three nerve conduction studies were performed and 58 of the tests were abnormal. The most commonly affected nerve was the median sensory (10). For patients with repeated tests, the mean time between tests was 169 days (SD 140 days). There was a significant difference between the initial and follow up test (McNemar's change test p=0.009). In subset analysis of motor and sensory abnormalities, there was no significant difference (p=0.07). The most common neuropathy identified in this cohort was the median sensory. Overall, there was improvement in the nerve conduction abnormalities examined. This study suggests that the prognosis for recovery after burn related neuropathy is good.

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Occurrence of nervous system involvement in SIRS

Cited by 9 publications

References 43 publications

Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review

Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review

Systemic Inflammation following Hind-Limb Ischemia-Reperfusion Affects Brain in Neonatal Mice

Assessment of Recovery From Burn-Related Neuropathy by Electrodiagnostic Testing

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