Neuropsychiatric symptoms in the context of hemodynamic disruption during septic shock

Abstract

BACKGROUND

Septic shock represents one of the most severe critical illness types, characterized by significant hemodynamic disorders and neuropsychiatric symptoms. This study aimed to investigate the association mechanism between hemodynamic indicators and neuropsychiatric symptoms in patients with septic shock, revealing potential pathophysiological connections.

AIM

To investigate the link between hemodynamic parameters and neuropsychiatric symptoms in septic shock.

METHODS

A retrospective case-control study involving 132 patients with septic shock. Multiple assessment tools were employed, including the Confusion Assessment Method, Hospital Anxiety and Depression Scale, Posttraumatic Stress Disorder Scale, and Mini-Mental State Examination, systematically evaluating patients’ neuropsychiatric symptoms and hemodynamic indicators.

RESULTS

Patient mean age was 52.4 ± 12.3 years, with 68.5% males. Multivariate analysis revealed significant correlations between neuropsychiatric symptom severity and mean arterial pressure < 65 mmHg [odds ratio (OR) = 2.7], lactate levels > 4 mmol/L (OR = 3.1), and elevated interleukin-6 inflammatory factors (OR = 2.4). Neuropsychiatric symptom incidence rates were: Delirium 37.1%; anxiety 28.8%; depression 24.2%; and posttraumatic stress disorder 19.7%.

CONCLUSION

Hemodynamic disorders in patients with septic shock are closely associated with neuropsychiatric symptoms, influencing central nervous system function through complex inflammatory and neurotransmitter pathways.

Keywords: Septic shock; Hemodynamics; Neuropsychiatric symptoms; Delirium

Core Tip: Septic shock induces severe hemodynamic disturbances, which are closely linked to neuropsychiatric symptoms such as delirium, anxiety, depression, and posttraumatic stress disorder. This study highlighted the impact of impaired cerebral perfusion, inflammatory cascades, and neurotransmitter imbalances on cognitive function. Key hemodynamic markers, including low cardiac output, elevated lactate, and reduced mean arterial pressure, significantly correlated with neuropsychiatric symptom severity. Early hemodynamic optimization and inflammation control may mitigate these complications and improve patient outcomes. These findings provide insights into the pathophysiological mechanisms underlying neuropsychiatric manifestations in septic shock, emphasizing the need for targeted interventions in patients who are critically ill.