Septic Encephalopathy

Ziaja, Marek

doi:10.1007/s11910-013-0383-y

Cited by 76 publications

(95 citation statements)

References 89 publications

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“…Although it is known that sepsis may cause encephalopathy via distant organ damage such as seen in liver and kidney, it is also possible to see encephalopathy without any distant organ damage. This may support the idea of SAE resulting from the systemic inflammation related to sepsis [4,7]. …”

Section: Discussionsupporting

confidence: 77%

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Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy

Arslan

Ekinci

Arıcı

et al. 2017

Libyan Journal of Medicine

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Despite recent advances in antibiotic therapy, sepsis remains a major clinical challenge in intensive care units. Here we examined the anti-inflammatory and antioxidant effects of Ecballium elaterium (EE) on brain, and explored its therapeutic potential in an animal model of sepsis-associated encephalopathy (SAE) [induced by cecal ligation and puncture (CLP)].Thirty rats were divided into three groups of 10 each: control, sepsis, and treatment. Rats were subjected to CLP except for the control group, which underwent laparatomy only. The treatment group received 2.5 mg/kg EE while the sepsis group was administered by saline. Twenty-four hours after laparotomy, animals were sacrificied and the brains were removed. Brain homogenates were prepared to assess interleukin 1beta (IL-1β), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), total antioxidant capacity (TAC), and total oxidant status (TOS). Brain tissue sections were stained by hematoxylin and eosin (H&E) to semi-quantitatively examine the histopathologic changes such as neuron degeneration, pericellular/perivascular edema and inflammatory cell infiltration in the cerebral cortex.We found a statistically significant reduction in brain tissue homogenate levels of TNF-α 59.5 ± 8.4/50.2 ± 6.2 (p = 0.007) and TOS 99.3 ± 16.9/82.3 ± 7.8 (p = 0.01) in rats treated with EE; although interleukin 6 levels were increased in the treatment group compared to the sepsis group, this was not statistically significant. Neuronal damage (p = 0.00), pericellular/perivascular edema and inflammatory cell infiltration (p = 0.001) were also significantly lower in the treatment group compared to those in the sepsis group.These data suggest that Ecballium elaterium contains some components that exert protective effects against SAE in part by attenuating accumulation of proinflammatory cytokines, which may be important contributors to its anti-inflammatory effects during sepsis.

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Section: Discussionsupporting

confidence: 77%

“…It has been accepted as a gold standard model for sepsis and SAE [7]. This model may show central nervous system involvement as well as hepatic, pulmonary and renal dysfunctions [5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy

Arslan

Ekinci

Arıcı

et al. 2017

Libyan Journal of Medicine

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“…Sepsis-associated encephalopathy is a reversible dysfunction of the central nervous system that has a wide spectrum of clinical presentations from stupor and coma to severe agitation and irritability [2]. The pathogenesis of SEA is likely to be multifactorial [1].…”

Section: Discussionmentioning

confidence: 99%

“…An encephalopathy with variable severity is found to occur in 9-71% of septic adult patients [2]. The frequency of SEA or any other neurologic disability has not been demonstrated in children with sepsis [3].…”

Section: Introductionmentioning

confidence: 99%

Sepsis-Associated Encephalopathy in a Child with the Torsion of Meckel’s Diverticulum

2016

Ann Clin Anal Med

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ÖzetSepsis-ilişkili ensefalopati enfeksiyona sistemik yanıta ikincil gelişen yaygın bir beyin fonksiyon bozukluğudur ve yüksek mortalite oranı ile ilişkilidir. Biz 4 yaşın-daki sepsis-ilişkili ensefalopati görülen bir erkek hastayı sunduk. Hasta karın ağ-rısı ve kusma ile başvurdu. Yatışının ikinci gününde, dikkat bozukluğu, konfüzyon ve deliryumun eşlik ettiği bilinç bozukluğu geliştirdi. Rutin laboratuar testleri, beyin manyetik rezonans görüntüleme ve beyin omurilik sıvısı incelemesi normaldi. Elektroensefalografide sağ hemisferde epileptiform deşarjların eşlik ettiği yük-sek voltajlı yavaş dalga aktivitesi izlendi. Hasta acilen ameliyata alındı ve tortiöz, gangrenöz Meckel divertikülü ve komşuluğundaki ince bağırsağa uzanan iskemi alanı görüldü ve bu alanlar çıkarıldı. Hastanın üçüncü gün bilinci normale döndü ve izlemde sekelsiz olarak taburcu edildi. Sepsis-ilişkili ensefalopati hastalarında kötü prognozun üstesinden gelmek için, belirtilerinin erken tanınması ve altta yatan nedenin uygun tedavisi çok önemlidir. Anahtar KelimelerSepsis İlişkili Ensefalopati; Meckel Divertikülü; Çocuk Abstract Sepsis-associated encephalopathy (SEA) is a diffuse brain dysfunction secondary to the systemic response to infection and is associated with high mortality rate. We report a 4-year-old boy with SEA. He presented with abdominal pain and vomiting. On the second day of admission, he developed consciousness disturbance with impaired attention, confusion and delirium. Routine laboratory tests, brain magnetic resonance imaging and cerebrospinal fluid examination were normal. Electroencephalography (EEG) showed high-voltage slow wave activity on the right hemisphere with epileptiform discharge. He immediately underwent surgery and a torsed, gangrenous Meckel's diverticulum with extension of ischemia to adjacent small bowel was seen and resected. His consciousness had become normal by the third day and he was discharged without any sequela. To overcome a poor prognosis in patients with SEA, the early recognition of the symptoms of SEA and also appropriate treatment of the underlying cause are essential.

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“…While there is substantial variation in the percentages of patients with any specific organ involvement, pulmonary, renal, cardiovascular, hepatic, neurologic, and hematologic dysfunction may result from primary and secondary causes Iskander et al, 2013;Stubbs et al, 2013;Ziaja, 2013;Fiusa et al, 2015). In all populations, the mortality rate of sepsis greatly increases as multiple organ systems fail Iskander et al, 2013;Romanovsky et al, 2014).…”

Section: Patient Heterogeneitymentioning

confidence: 99%

Could Biomarkers Direct Therapy for the Septic Patient?

Sims

Nguyen

Mayeux

2016

Journal of Pharmacology and Experimental Therapeutics

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Sepsis is a serious medical condition caused by a severe systemic inflammatory response to a bacterial, fungal, or viral infection that most commonly affects neonates and the elderly. Advances in understanding the pathophysiology of sepsis have resulted in guidelines for care that have helped reduce the risk of dying from sepsis for both children and older adults. Still, over the past three decades, a large number of clinical trials have been undertaken to evaluate pharmacological agents for sepsis. Unfortunately, all of these trials have failed, with the use of some agents even shown to be harmful. One key issue in these trials was the heterogeneity of the patient population that participated. What has emerged is the need to target therapeutic interventions to the specific patient's underlying pathophysiological processes, rather than looking for a universal therapy that would be effective in a "typical" septic patient, who does not exist. This review supports the concept that identification of the right biomarkers that can direct therapy and provide timely feedback on its effectiveness will enable critical care physicians to decrease mortality of patients with sepsis and improve the quality of life of survivors.

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Septic Encephalopathy

Cited by 76 publications

References 89 publications

Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy

Effects of Ecballium elaterium on brain in a rat model of sepsis-associated encephalopathy

Sepsis-Associated Encephalopathy in a Child with the Torsion of Meckel’s Diverticulum

Could Biomarkers Direct Therapy for the Septic Patient?

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