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Published on: June 15, 2019
Current knowledge and challenges of sepsis-associated encephalopathy
Manu Shankar-Hari1, Sarah Benghanem2,3, Lena Bourhy4
1Centre for Critical Illness Research, School of Immunology and Microbial Sciences, King's College London, London, UK.
Intensive Care Medicine
|June 16, 2026
Summary
Sepsis-associated encephalopathy (SAE) is a severe complication affecting up to 70% of ICU patients, leading to cognitive impairment and increased mortality. Understanding SAE
Area of Science:
- Neuroscience
- Critical Care Medicine
- Pathophysiology
Background:
- Sepsis-associated encephalopathy (SAE) affects up to 70% of intensive care unit patients.
- SAE is characterized by altered consciousness, electroencephalographic changes, and seizures.
- It is associated with increased mortality and long-term cognitive deficits.
Purpose of the Study:
- To review current data on the epidemiology, mechanisms, characteristics, and complications of SAE.
- To highlight priorities for therapeutic advancements in SAE.
- To emphasize the need for better understanding of SAE pathophysiology and biomarkers.
Main Methods:
- This review synthesizes current scientific literature on sepsis-associated encephalopathy.
- It examines epidemiological data, pathophysiological mechanisms, clinical features, and outcomes.
- The review also discusses current management strategies and future research directions.
Main Results:
- SAE pathophysiology involves neurotransmission disturbances, cellular dysfunction, neuroinflammation, and ischemia.
- Key affected brain regions include the frontal cortex, hippocampus, limbic system, and brainstem.
- Increased severity of SAE correlates with higher mortality and worse long-term outcomes.
Conclusions:
- Effective management of SAE currently focuses on sepsis control and delirium management.
- Developing specific treatments requires a deeper understanding of SAE pathophysiology and identification of biomarkers.
- Further research into experimental models and diagnostic/prognostic biomarkers is crucial for therapeutic progress.
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