Dabrowski Wojciech, Siwicka-Gieroba Dorota, Gasinska-Blotniak Malgorzata, Zaid Sami, Jezierska Maja, Pakulski Cezary, Williams Roberson Shawniqua, Wesley Ely Eugene, Kotfis Katarzyna
Department of Anaesthesiology and Intensive Care, Medical University of Lublin, 20-954 Lublin, Poland.
Department of Anaesthesia, Al-Emadi-Hospital Doha, P.O. Box 5804 Doha, Qatar.
Medicina (Kaunas). 2020 Sep 13;56(9):469. doi: 10.3390/medicina56090469.
Delirium, an acute alteration in mental status characterized by confusion, inattention and a fluctuating level of arousal, is a common problem in critically ill patients. Delirium prolongs hospital stay and is associated with higher mortality. The pathophysiology of delirium has not been fully elucidated. Neuroinflammation and neurotransmitter imbalance seem to be the most important factors for delirium development. In this review, we present the most important pathomechanisms of delirium in critically ill patients, such as neuroinflammation, neurotransmitter imbalance, hypoxia and hyperoxia, tryptophan pathway disorders, and gut microbiota imbalance. A thorough understanding of delirium pathomechanisms is essential for effective prevention and treatment of this underestimated pathology in critically ill patients.
谵妄是一种以意识混乱、注意力不集中和觉醒水平波动为特征的急性精神状态改变，是危重症患者常见的问题。谵妄会延长住院时间，并与更高的死亡率相关。谵妄的病理生理学尚未完全阐明。神经炎症和神经递质失衡似乎是谵妄发生的最重要因素。在本综述中，我们介绍了危重症患者谵妄最重要的发病机制，如神经炎症、神经递质失衡、缺氧和高氧、色氨酸途径紊乱以及肠道微生物群失衡。深入了解谵妄的发病机制对于有效预防和治疗危重症患者中这种被低估的病症至关重要。
