Archive 1995–2023

Sepsis-associated encephalopathy (SAE) is a centralnervous system disorder which develops in the course of an infection. About 1/3 of patients with an infection manifest qualitative consciousness disturbances possiblyrelated to SAE. This phenomenon is underdiagnosed inboth the general and specialised practices and in particular in the emergency medicine settings.This review paper is aimed at specifying the pathomechanisms, diagnostic procedures and differentialdiagnostics of SAE. The SAE diagnosis is possible in patients with qualitative or quantitative consciousness disturbances or a cognitive and executive functioning impairment who fulfil the sepsis diagnostic criteria. In differential diagnosis and monitoring of SAE patients the clinimetric methods are used: Richmond Agitation and Sedation Scale (RASS), Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Sequential Organ Failure Assessment score (SOFA), along with neurophysiology (electroencephalography), neuroimaging (magnetic resonance imaging) and laboratory tests (C-reactive protein, procalcitonin, biomarkers of central nervous system and blood-brain barrier damage). The treatment of SAE patients is based on the infection control and homeostasis maintenance. During symptomatic treatment, benzodiazepines should be avoided, and dexmedetomidine seems to be beneficial. Potentially, the treatment with intravenous immunoglobulins may be favourable.