Delirium-a letter update
DOI:
https://doi.org/10.18203/2320-6012.ijrms20240563Keywords:
Delirium, Predisposing and precipitating, De novo synthesisAbstract
Delirium is essentially acute brain failure that results from stressors that surpass the brain's homeostatic reserve. Delirium is caused by a combination of risk factors that are both predisposing and precipitating. Advanced age, frailty, medication exposure or withdrawal, sedation depth, and sepsis are all known risks. Stressors most likely have coordinated rather than independent effects, and the systems they affect are linked rather than separate. Changes in the blood-brain barrier and the central nervous system's de novo synthesis or elaboration of inflammatory mediators account for the pathophysiology of delirium. It also seems that neuro-inflammatory activity contributes to the dysregulation of neurotransmitters.
References
AGS/NIA Delirium Conference Writing Group, Planning Committee and Faculty. The American Geriatrics Society/National Institute on Aging Bedside-to-Bench Conference: Research Agenda on Delirium in Older Adults. J Am Geriatr Soc. 2015;63(5):843-52.
Grover S, Ghormode D, Ghosh A, Avasthi A, Chakrabarti S, Mattoo SK, Malhotra S. Risk factors for delirium and inpatient mortality with delirium. J Postgrad Med. 2013;59(4):263-70.
Rea K, Dinan TG, Cryan JF. The microbiome: A key regulator of stress and neuroinflammation. Neurobiol Stress. 2016;(4):23-33.
Mehta N. Mind-body Dualism: A critique from a Health Perspective. Mens Sana Monogr. 2011;9(1):202-9.
Ankravs MJ, McKenzie CA, Kenes MT. Precision-based approaches to delirium in critical illness: A narrative review. Pharmacotherapy. 2023;431(11):1139-53.
