Section Translational Neuroimmunology, Department for Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Center for Sepsis Control and Care, Jena University Hospital, 07747, Jena, Germany.
Crit Care. 2023 May 31;27(1):214. doi: 10.1186/s13054-023-04497-4.
Sepsis is the most common cause of admission to intensive care units worldwide. Sepsis patients frequently suffer from sepsis-associated encephalopathy (SAE) reflecting acute brain dysfunction. SAE may result in increased mortality, extended length of hospital stay, and long-term cognitive dysfunction. The diagnosis of SAE is based on clinical assessments, but a valid biomarker to identify and confirm SAE and to assess SAE severity is missing. Several blood-based biomarkers indicating neuronal injury have been evaluated in sepsis and their potential role as early diagnosis and prognostic markers has been studied. Among those, the neuroaxonal injury marker neurofilament light chain (NfL) was identified to potentially serve as a prognostic biomarker for SAE and to predict long-term cognitive impairment. In this review, we summarize the current knowledge of biomarkers, especially NfL, in SAE and discuss a possible future clinical application considering existing limitations.
脓毒症是全球范围内导致重症监护病房入院的最常见原因。脓毒症患者经常患有脓毒症相关性脑病（SAE），反映出急性脑功能障碍。SAE 可能导致死亡率增加、住院时间延长和长期认知功能障碍。SAE 的诊断基于临床评估，但缺乏用于识别和确认 SAE 以及评估 SAE 严重程度的有效生物标志物。已经在脓毒症中评估了几种表明神经元损伤的基于血液的生物标志物，并且已经研究了它们作为早期诊断和预后标志物的潜在作用。其中，神经轴索损伤标志物神经丝轻链（NfL）被确定为 SAE 的潜在预后生物标志物，并可预测长期认知障碍。在这篇综述中，我们总结了 SAE 中生物标志物（特别是 NfL）的最新知识，并考虑到现有局限性讨论了未来可能的临床应用。
