SAEED GHANDER KADASAH , ABDULLAH NASSER AL KHAMIS , ASMA HAMAD ALJEDIBA , TURKI MOHAMMED ALGHURAYBI , ABDULAZIZ FATIS J ALMALKI
DOI: https://doi.org/Sepsis-associated encephalopathy (SAE) and sepsis-associated delirium (SAD) represent common forms of acute brain dysfunction in patients with sepsis and are strongly associated with short- and long-term morbidity and mortality . These syndromes arise from a complex interplay of systemic inflammation, microcirculatory failure, blood–brain barrier disruption, and dysregulated neurotransmission rather than direct central nervous system infection . Clinically, SAE spans a spectrum from subtle inattention and sleep–wake cycle disturbance to profound coma, while delirium is the dominant bedside manifestation in many patients . Accumulating evidence demonstrates that the duration and severity of delirium are independently associated with long-term cognitive impairment, functional disability, and the development of post-intensive care syndrome (PICS) . Because care of these patients is distributed across the prehospital, emergency, intensive care, psychiatric, laboratory, and nursing domains, an integrated multidisciplinary approach is required to optimize outcomes. This narrative review synthesizes current knowledge on mechanisms, diagnosis, and management of SAE and SAD from the perspectives of psychiatrist consultants, paramedics, adult critical care nurses, medical laboratory specialists, and nursing technicians. We summarize key epidemiologic data; outline contemporary concepts of pathophysiology with an emphasis on neuroinflammation and biomarkers; discuss prehospital recognition of sepsis and altered mental status; review guideline-based intensive care unit (ICU) strategies for pain, agitation, sedation, delirium, immobility, and sleep (PADIS); and highlight the roles of consultation–liaison psychiatry and the clinical laboratory in assessment and follow-up . Finally, we describe the long-term consequences of SAE within the broader construct of PICS and propose practical multidisciplinary pathways to improve prevention, early detection, and rehabilitation. Understanding SAE and SAD as shared responsibilities across disciplines is essential to reduce the substantial neurologic and psychological burden borne by survivors of sepsis and their families.
