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Related Experiment Video

Updated: Jun 12, 2025

Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound
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Alterations in Regional Brain Microcirculation in Patients with Sepsis: A Prospective Study Using Contrast-Enhanced

Duc Nam Nguyen1, Luc Huyghens2, Truc Mai Nguyen3

  • 1Department of Critical Care Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. ducnam_nguyen@uzbrussel.be.

Neurocritical Care
|September 23, 2024
PubMed
Summary

Brain microcirculation changes in sepsis patients are linked to poor outcomes. Contrast-enhanced brain ultrasound (CEUS) revealed prolonged time-to-peak in non-survivors, indicating altered brain perfusion in critical illness.

Keywords:
Brain microcirculationCerebral blood flowContrast-enhanced brain ultrasoundEncephalopathySepsis

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Medical Imaging

Background:

  • Regional brain microcirculation alterations in sepsis are not well understood.
  • Contrast-enhanced brain ultrasound (CEUS) with microbubbles can assess brain microcirculation.
  • Sepsis poses a significant risk for neurological complications.

Purpose of the Study:

  • To investigate regional brain microcirculation changes in sepsis patients using CEUS.
  • To correlate these microcirculatory alterations with clinical outcomes, brain injury, and encephalopathy.
  • To compare sepsis patients with nonseptic postoperative controls.

Main Methods:

  • CEUS was employed to evaluate brain microcirculation over three days in 58 sepsis patients and 10 controls.
  • Time-intensity perfusion curve variables (time-to-peak, peak intensity) were measured.
  • Simultaneous assessments included hemodynamic parameters, cerebral blood flow, middle cerebral artery flow velocities, and brain autoregulation; CT imaging and neurological scales evaluated brain injury and encephalopathy.

Main Results:

  • Sepsis patients showed higher rates of encephalopathy (72%) and structural brain injury (19%).
  • Impaired brain autoregulation was observed in 40% of sepsis patients.
  • Altered microcirculation (prolonged time-to-peak, decreased peak intensity) was found in non-survivors' brains, specifically in the left lentiform nucleus and temporoparietal white matter; prolonged time-to-peak independently predicted worse outcomes.

Conclusions:

  • Critically ill sepsis patients exhibit regional brain microcirculation alterations.
  • These microcirculatory changes are associated with poorer patient outcomes.
  • CEUS is a valuable tool for assessing brain microcirculation in sepsis.