Title |
Are you Ernest Shackleton, the polar explorer? Refining the criteria for delirium and brain dysfunction in sepsis
|
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Published in |
Journal of Intensive Care, March 2017
|
DOI | 10.1186/s40560-017-0218-z |
Pubmed ID | |
Authors |
Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande, Nicola Latronico |
Abstract |
The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunctions in this consensus definition were identified as an organ-specific Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score ≥ 2 points. The quick SOFA (qSOFA) considers altered mentation indicating brain dysfunction when the Glasgow Coma Scale (GCS) score is ≤13 or ≤14. However, concern has been expressed that the revised criteria may lead to a failure in recognizing the signs of potentially lethal organ dysfunction and thus sepsis. Patients with delirium have a fluctuating course, and GCS can be normal or only slightly reduced at the time when signs of delirium are already present. We here report an illustrative case showing how an acute, initially unrecognized, urinary tract infection caused acute brain dysfunction with profound behavioral and cognitive dysfunction despite normal GCS, hence not meeting the criteria for sepsis. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 2 | 25% |
Italy | 2 | 25% |
United Kingdom | 1 | 13% |
Unknown | 3 | 38% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 50% |
Scientists | 3 | 38% |
Practitioners (doctors, other healthcare professionals) | 1 | 13% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 58 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 7 | 12% |
Student > Doctoral Student | 7 | 12% |
Student > Postgraduate | 6 | 10% |
Other | 5 | 9% |
Professor | 5 | 9% |
Other | 13 | 22% |
Unknown | 15 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 33 | 57% |
Neuroscience | 4 | 7% |
Nursing and Health Professions | 3 | 5% |
Biochemistry, Genetics and Molecular Biology | 2 | 3% |
Physics and Astronomy | 1 | 2% |
Other | 3 | 5% |
Unknown | 12 | 21% |