Gravitational ischemia in the brain—may contribute to delirium and mortality in the intensive care unit

Gravitational ischemia in the brain—may contribute to delirium and mortality in the intensive care unit

•Gravitational ischemia in the brain results from the mass effect of one part of the brain upon another in a gravitational field.•The finding that hypoactive delirium was more associated with mortality was consistent with hypoactive patients spending more time in a single body position.•Decreased ar...

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Bibliographic Details
Published in:Cardiovascular pathology Vol. 54; p. 107349
Main Authors: Jaster, J. Howard, Biagi, Roberto, Giannì, Aldo Bruno, Ottaviani, Giulia
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-09-2021
Subjects:
Brain
Delirium
Humans
Intensive Care Units
Ischemia
Online Access:Get full text
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Summary:•Gravitational ischemia in the brain results from the mass effect of one part of the brain upon another in a gravitational field.•The finding that hypoactive delirium was more associated with mortality was consistent with hypoactive patients spending more time in a single body position.•Decreased arterial CO2 in the brain causes vasoconstriction, which reduces blood flow and worsens ischemia in medullary autonomic nuclei.•Brainstem focal ischemia may result in the initiation of intense autonomic discharges, which can occasionally be fatal.•Abnormal neural discharge to the heart via dorsal motor nucleus of vagus nerve would result in arrhythmias and sudden death.
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Editorial-2
ObjectType-Commentary-1
ISSN:1054-8807
1879-1336
DOI:10.1016/j.carpath.2021.107349