Brain Tissue Oxygenation in Patients with Septic Shock: a Feasibility Study.

Area of Science:

• Critical care medicine
• Neuroscience
• Medical technology

Background:

• Delirium is prevalent in critically ill patients, linked to higher mortality and cognitive deficits.
• The underlying causes of delirium remain largely unknown.
• Septic shock patients face a high risk of developing delirium.

Purpose of the Study:

• To evaluate the feasibility of using near-infrared spectroscopy (NIRS).
• To assess brain tissue oxygenation in patients with septic shock.
• To explore NIRS as a tool for understanding delirium in critical illness.

Main Methods:

• Prospective observational study in a medical-surgical intensive care unit (ICU).
• Recruitment of patients with severe sepsis or septic shock.
• Utilized FORESIGHT NIRS monitor for frontal lobe oxygenation assessment (first 72 hours ICU).
• Collected concurrent physiological data and screened for delirium using Confusion Assessment Method-ICU.

Main Results:

• Ten septic shock patients were recruited; NIRS captured 81% of data with no adverse events.
• Brain tissue oxygenation showed significant variability in relation to physiological parameters (MAP, HR, SpO2).
• Mean brain tissue oxygen levels were significantly lower in patients with sustained delirium.

Conclusions:

• Near-infrared spectroscopy is a feasible method for monitoring brain tissue oxygenation in septic shock.
• This study establishes a foundation for larger investigations into brain oxygenation, physiology, and neurological dysfunction.
• Further research can explore the relationship between impaired brain oxygenation and delirium development.