Glymphatic dysfunction: a unifying hypothesis for delirium - PubMed
4 hours ago
- #glymphatic system
- #neurocritical care
- #delirium pathophysiology
- The glymphatic system's dysfunction is proposed as a key mechanism in the development of delirium, linking various risk factors and triggers.
- Major delirium risk factors like aging, dementia, cardiovascular disease, and renal failure are associated with reduced glymphatic clearance.
- Common delirium triggers such as infection, surgery, and sleep deprivation have been shown to impair glymphatic function.
- Intensive care interventions, including sedation, opioid administration, and noradrenaline, can suppress glymphatic clearance and contribute to delirium.
- Impaired glymphatic flow may lead to the accumulation of neurotoxic metabolites and pro-inflammatory cytokines, disrupting neural networks and causing delirium.
- Recognizing glymphatic impairment in delirium could open new research and therapeutic avenues to preserve brain fluid clearance in critically ill patients.