Publication:

Delirium-a letter update

Delirium is essentially acute brain failure that results from stressors that surpass the brain's homeostatic reserve. Delirium is caused by a combination of risk factors that are both predisposing and precipitating. Advanced age, frailty, medication exposure or withdrawal, sedation depth, and sepsis are all known risks. Stressors most likely have coordinated rather than independent effects, and the systems they affect are linked rather than separate. Changes in the blood-brain barrier and the central nervous system's de novo synthesis or elaboration of inflammatory mediators account for the pathophysiology of delirium. It also seems that neuro-inflammatory activity contributes to the dysregulation of neurotransmitters.