From the Research
Treatment of Septic Encephalopathy
- The treatment of septic encephalopathy is primarily focused on managing the underlying infection and providing supportive care 1, 2, 3.
- There is no specific prophylactic or targeted therapy to reduce or minimize brain damage in septic patients, and clinical management is limited to treating the underlying infection 1, 3.
- Treatment relies on proper identification of the causative pathogen and rapidly initiated adequate empirical or tailored antibiotic therapy, fluid and electrolyte management 4.
- In the presence of brain abscess(es) or mycotic aneurysm(s), surgery or interventional neuroradiology must be considered 4.
- Pharmacological approaches to prevent delirium include the use of dexmedetomidine and melatonin and its derivatives, although their use is limited 4.
- Non-pharmacological bundles of interventions, such as promotion of sleep, cognitive stimulation, early mobilization, and adequate therapy of pain, are of proven efficacy to prevent delirium, including sepsis 4.
- Experimental promising therapies include the use of non-bacteriolytic antibiotics and the reduction of the toxic effects of microglial activation 4.
Supportive Care
- Maintaining adequate perfusion pressure and preventing hypoxia and hypocapnia are primary therapeutic goals 5.
- The infusion of branched chain amino acids may be beneficial, although its use is controversial and requires further investigation 5.
- Glutamate receptor antagonists, new radical scavengers, NO- and PARS-inhibitors may be suitable for the prophylaxis or early therapy of septic encephalopathy, although further research is needed 5.