scholarly journals A Case Series on Critically Ill Pregnant or Newly Delivered Patients with Covid-19, Treated at Karolinska University Hospital, Stockholm

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Rasha El-ahmad Polcer ◽  
Elin Jones ◽  
Karin Pettersson
Keyword(s):  
Intensive Care ◽  
Pregnant Women ◽  
Critically Ill ◽  
Invasive Mechanical Ventilation ◽  
The Other ◽  
University Hospital ◽  
High Flow Oxygen ◽  
Computer Tomography Scan ◽  
Gestational Week ◽  
Time Of Admission

In this retrospective report, we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21 + 4 and 22 + 5 and treated during their antenatal period; meanwhile, the other two were admitted within 1 week postpartum. All of them were in need of intensive care: one was treated with high flow oxygen therapy, the other four with invasive mechanical ventilation (three with endotracheal intubation and one with extracorporeal membrane oxygenation). Age above thirty, overweight, and gestational diabetes are notable factors in the cases presented. At the time of admission, they all presented with symptoms such as fever, cough, and dyspnea. Chest imaging with computer tomography scan was performed in each case and demonstrated multifocal pneumonic infiltrates in all of them, but no pulmonary embolism was confirmed in any. Neither did the echocardiogram indicate any cardiomyopathy. Four of the patients have been discharged from the hospital, with an average of 20 hospital days. One antenatal pregnant woman needed prolonged ECMO therapy; in gestational week 27 + 3 , she went into cardiac arrest, resulting in an urgent C-section on maternal indication. At the time of writing, she is still hospitalized. In coherence with other published reports, our cases indicate that critically ill pregnant women infected by SARS-Cov-2 may develop severe respiratory distress syndrome requiring prolonged intensive care. The material is limited for conclusions to be made; more detailed information on symptoms, treatment, and outcomes for pregnant and postpartum women managed in intensive care is therefore needed.

scholarly journals A Case Series on Critically Ill Pregnant or Newly Delivered Patients with Covid-19, Treated at Karolinska University Hospital, Stockholm

2020 ◽  
Author(s):  
Rasha El-ahmad (Polcer) ◽  
Karin Pettersson ◽  
Elin Jones
Keyword(s):  
Intensive Care ◽  
Pregnant Women ◽  
Critically Ill ◽  
Invasive Mechanical Ventilation ◽  
The Other ◽  
University Hospital ◽  
High Flow Oxygen ◽  
Computer Tomography Scan ◽  
Gestational Week ◽  
Time Of Admission

In this retrospective report we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21+4 to 22+5 and treated during their antenatal period, meanwhile the other two were admitted within 1 week postpartum. All of them were in a need of intensive care, one was treated with high flow oxygen therapy, the other four with invasive mechanical ventilation (three with endotracheal intubation and one with extra corporeal membrane oxygenation). Age above thirty, overweight and gestational diabetes are notable factors in the cases presented. At the time of admission, they all presented with symptoms as fever, cough and dyspnea. Chest imaging with computer tomography scan was performed in each case and demonstrated multifocal pneumonic infiltrates in all of them but no pulmonary embolism was confirmed in any. Neither did the echocardiogram indicates any cardiomyopathy. Four of the patients have been discharged from the hospital, with an average of 20 hospital days. One antenatal pregnant woman needed prolonged ECMO therapy, in gestational week 27+3 she went into cardiac arrest, resulting in an urgent c-section on maternal indication. At the time of writing she is still hospitalized. In coherence with other published reports our cases indicate that critically ill pregnant women infected by SARS-Cov-2 may develop severe respiratory distress syndrome requiring prolonged intensive care. The material is limited for conclusions to be taken, more detailed information on symptoms, treatment, and outcomes for pregnant and postpartum women managed in intensive care is therefore needed.

Predictors of Mortality of Critically Ill Gynecological Patients

2016 ◽  
Vol 8 (2) ◽  
pp. 96-100
Author(s):  
Rahat Qureshi ◽  
Sheikh Irfan Ahmed ◽  
Amir Raza ◽  
Azra Amerjee
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critically Ill ◽  
Gynecological Cancer ◽  
Invasive Mechanical Ventilation ◽  
Central Line ◽  
University Hospital ◽  
Arterial Line ◽  
Predictors Of Mortality ◽  
Line Insertion

ABSTRACT Background Gynecological patients with serious underlying morbidities require admission into intensive care units (ICUs) albeit being few in numbers. Objectives To review gynecological cases with non-pregnancyrelated illness, admitted to ICU with respect to diagnosis, associated risk factors, intervention required, aspects of management, and rate of mortality. Materials and methods Retrospective record view of gynecological patients admitted in the ICU from 2005 to 2014. Setting Aga Khan University Hospital, Karachi. Findings Twenty-six patients were admitted with complications secondary to gynecological indications. The most common reason was pulmonary edema (26.9%); sepsis was documented in 23.1% of all patients. Hemorrhagic shock was found in 11.5% gynecological ICU admissions, cardiogenic shock in 15.4%, and renal failure in 7.7%. Fourteen critically ill women with gynecological cancer were admitted to the ICU (ovarian cancer, n = 8; cervical cancer, n = 1; and endometrial cancer, n = 5). The overall mortality of gynecological patients was 26.92%. The most common interventions were mechanical ventilation (96%) followed by arterial line insertion (88%) and central line insertion (85%). Conclusion Critically ill gynecological patients requiring invasive mechanical ventilation, central hemodynamic monitoring, and invasive arterial pressure monitoring should be admitted to an intensive care unit. How to cite this article Qureshi R, Ahmed SI, Raza A, Amerjee A. Predictors of Mortality of Critically Ill Gynecological Patients. J South Asian Feder Obst Gynae 2016;8(2):96-100.

scholarly journals Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Improve Patient Care ◽  
University Hospital ◽  
Treatment Modalities ◽  
Control Group ◽  
Electrolyte Disturbances ◽  
Electrolyte Loss

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.

scholarly journals Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study

2013 ◽  
pp. 184-188 ◽  
Author(s):  
Alvaro Sanabria ◽  
Ximena Gomez ◽  
Valentin Vega ◽  
Luis Carlos Dominguez ◽  
Camilo Osorio
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Critically Ill ◽  
Medical Condition ◽  
Prolonged Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Adult Patients ◽  
Saps Ii Score

Introduction: There are no established guidelines for selecting patients for early tracheostomy. The aim was to determine the factors that could predict the possibility of intubation longer than 7 days in critically ill adult patients. Methods: This is cohort study made at a general intensive care unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associated with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a patient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation. Conclusions: It was not possible to predict early extubation in critically ill adult patients with invasive mechanical ventilation with common clinical scales used at the ICU. However, the probability of successfully weaning patients from mechanical ventilation without a tracheostomy is low after the eighth day of intubation.

Perfil de pacientes críticos com risco de olho seco: estudo transversal

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Jéssica Araújo Olímpio ◽  
Jéssica Naiara de Medeiros Araújo ◽  
Vanessa Pinheiro Barreto ◽  
Raianny Alves Costa Medeiros ◽  
Mércio Gabriel de Araújo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Dry Eye ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Direct Care ◽  
University Hospital ◽  
Ocular Complications ◽  
Cross Sectional ◽  
The Mean

Aim: characterize the sociodemographic and clinical profile of patients with the diagnosis of dry eye risk nursing in intensive care unit. Methods: this is a cross-sectional study carried out at the intensive care unit of a university hospital located in the northeastern region of Brazil between January and July 2016. Results: it was observed that 51% of the patients were male, the mean age was 59.5 years, and 65.6% had a partner. Regarding the reasons for hospitalization, 53.1% were in the postoperative period and 46.9% were clinical patients; 49% were on invasive mechanical ventilation. Conclusion: to know the characteristics of patients with the diagnosis of dry-eye risk nursing in an intensive care unit becomes important in order to direct care for the prevention and early detection of the problem in order to reduce ocular complications

scholarly journals Limitations of the ARDS criteria during high-flow oxygen or non-invasive ventilation: Evidence from critically ill COVID-19 patients

2021 ◽  
Author(s):  
Michael Hultström ◽  
Ola Hellkvist ◽  
Lucian Covaciu ◽  
Filip Fredén ◽  
Robert Frithiof ◽  
...  
Keyword(s):  
Invasive Mechanical Ventilation ◽  
High Flow ◽  
University Hospital ◽  
Respiratory Support ◽  
Arterial Oxygen ◽  
Invasive Ventilation ◽  
Steady State Condition ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
High Flow Oxygen

Abstract Introduction The ratio of partial pressure of arterial oxygen to inspired oxygen fraction (PaO2/FIO2) during invasive mechanical ventilation (MV) is used as criteria to grade the severity of respiratory failure in acute respiratory distress syndrome (ARDS). During the SARS-CoV2 pandemic the use of PaO2/FIO2 ratio has been increasingly used in non-invasive respiratory support such as high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV). The grading of hypoxemia in non-invasively ventilated patients is uncertain. The main hypothesis, investigated in this study, was that the PaO2/FIO2 ratio does not change when switching between MV, NIV and HFNC. Methods This was a sub-study of a single-center prospective observational study of patients admitted to the intensive care unit (ICU) at Uppsala University Hospital in Sweden for critical COVID-19. In a steady state condition, the PaO2/FIO2 ratio was recorded before and after any change between two of the studied respiratory support techniques (i.e., HFNC, NIV and MV). Results A total of 148 patients were included in the present analysis. We find that any change in respiratory support from or to HFNC caused a significant change in PaO2/FIO2 ratio (up to 48 mmHg, from HFNC to MV). Changes in respiratory support between NIV and MV did not show consistent change in PaO2/FIO2 ratio. In patients classified as mild to moderate ARDS during MV, the change from HFNC to MV showed a variable increase in PaO2/FIO2 ratio ranging between 52 and 140 mmHg (median of 127 mm Hg). This made prediction of ARDS severity during MV from the apparent ARDS grade during HFNC impossible. Conclusion HFNC is associated with lower PaO2/FIO2 ratio than either NIV or MV in the same patient, while NIV and MV provided similar PaO2/FIO2 and thus ARDS grade by Berlin definition. The large variation of PaO2/FIO2 ratio precludes using ARDS grade as a measure of pulmonary damage during HFNC.

scholarly journals Comparison between dexmedetomidine and propofol as sedatives for critically ill patients in intensive care units

2018 ◽  
Vol 60 (1) ◽  
pp. 28-31
Author(s):  
Sabah N. AL-Saad ◽  
Haitham A. Sahib AI-Jaafari
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Null Hypothesis ◽  
Randomized Study ◽  
The Other ◽  
P Value ◽  
Target Level ◽  
Hemodynamic Stability ◽  
Haemodynamic Stability ◽  
Level Of Consciousness

Background: Regarding using of sedation in the intensive care unit (ICU) should allow the patient to be more comfortable, calm, cooperative, and at the same time easily arousable without delay niether weaning nor prolonged mechanical ventilation.Objective: The aim of my study is to compare the effect of dexmeditomidine Versus propofol for sedation and hemodynamic stability in a critically ill patient.Patient and method: A randomized study of 44 patients admitted to ICU; 22 of them received dexmedetomidine and the other 22 patients received propofol for sedation. The level of consciousness, blood pressure, heart rate, respiratory rate and requirement for adjuvants to reach the target level of sedation were monitored for the first 12 hours.Result: By applying Null hypothesis it was found that dexmedetomidine was significantly effective when compared with propofol for sedation with a p-value less than 0.001, while it was not significantly effective when compared with propofol plus adjuvant with p-value> 0.05.Conclusion: Dexmedetomidine is effective as a sole sedative agent with haemodynamic stability without the need to add any adjuvant to it, while propofol cause hypotension and bradycardia if used alone to reach our target level of sedation, but can be used with adjuvant to reach our target of sedation and haemodynamic stability.Keywords: Dexmedetomidine, Propofol, Sedation, ICU. مقارنة  عقار الديكسميديتوميدين مع عقار البربوفول كمواد مهدئة في مرضى يعانون حالة صحية حرجة في وحدة العناية المركزة. د. صباح نوري السعد د. هيثم عبد الستار صاحب  الخلاصة: خلفیة: إستعمال المھدئات في العنایة المركزة ینبغي أن تسمح للمریض أن یكون ھادئا ومتعاونا وفي الوقت نفسه سھولة التحفیز الصوتي دون تأخیر الفطام وكذلك عدم الاعتماد على أجھزة التنفس المیكانیكیة لفترات طویلة. في ھذه الدراسة قمنا بمقارنة تأثیر عقاري الدیكسمیدیتومیدین و البروبوفول كمھدئات للمرضى الذین ھم في حالة حرجة. الھدف من الدراسة: لمقارنة تأثیر الدیكسمیدیتومیدین مقابل البروبوفول للتھدئة والاستقرار في الدورة الدمویة للمریض الذي في حالة صحیة حرجة .   المرضى والأسلوب: دراسة عشوائیة من 44 مریض في وحدة العنایة المركزة، 22 منھم تلقى عقار الدیكسمیدیتومیدین و 22 مریض أخر تلقى البروبوفول لغرض التھدئة،تم أخذ قرائات مستوى الوعي وضغط الدم ومعدل ضربات القلب، ومعدل التنفس ومتطلبات المواد المساعدة للوصول إلى المستوى المطلوب من التھدئة,تمت المراقبة لمدة 12 ساعة الأولى. النتیجة: من خلال تطبیق فرضیة العدم وجدت أن عقار الدیكسمیدیتومیدین فعال بشكل ملحوظ أقل من 0.001 ، في حین انھا لیست كبیرة عند P بالمقارنة مع البروبوفول للتھدئة مع قیمة.1 = P مقارنة الدیكسمیدیتومیدین مع البروبوفول بأضافة مواد مساعدة مع قیمة الخلاصة: عقار الدیكسمیدیتومیدین فعال كعامل مھدئ وحید مع استقرار الدورة الدمویة دون الحاجة لإضافة أي مادة مساعدة لھا، في حین عقار البروبوفول یؤدي الى انخفاض ضغط الدم وبطء بضربات القلب إذا ما استخدمت وحدھا لتصل إلى مستوى ھدفنا من التھدئة، ولكن یمكن استخدامھا مع مادة مساعدة للوصول الى الھدف من التھدئة مع إستقرار الدورة الدمویة. الكلمات الدالة: الدیكسمیدیتومیدین ، البروبوفول، التھدئة،العنایة المركزة.  

scholarly journals The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3302
Author(s):  
Michał Czapla ◽  
Raúl Juárez-Vela ◽  
Vicente Gea-Caballero ◽  
Stanisław Zieliński ◽  
Marzena Zielińska
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Nutritional Risk ◽  
Risk Of Death ◽  
The Impact

Background: Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). Results: A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0–29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). Conclusions: Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient’s age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.

scholarly journals Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care expert consensus statement on the use of lung ultrasound in critically ill patients with coronavirus disease 2019 (ITACO)

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Luigi Vetrugno ◽  
Francesco Mojoli ◽  
Andrea Cortegiani ◽  
Elena Giovanna Bignami ◽  
Mariachiara Ippolito ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Working Group ◽  
Lung Ultrasound ◽  
Invasive Mechanical Ventilation ◽  
Italian Society ◽  
Expert Consensus ◽  
Consensus Statements

Abstract Background To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit. Methods A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging. Results A total of 20 statements were produced by the panel. Agreement was reached on 18 out of 20 statements (scoring 7–9; “appropriate”) in the first round of voting, while 2 statements required a second round for agreement to be reached. At the end of the two Delphi rounds, the median score for the 20 statements was 8.5 [IQR 8.9], and the agreement percentage was 100%. Conclusion The Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care produced 20 consensus statements on the use of lung ultrasound in COVID-19 patients admitted to the ICU. This expert consensus strongly suggests integrating lung ultrasound findings in the clinical management of critically ill COVID-19 patients.

scholarly journals AChE-activity in critically ill patients with suspected septic encephalopathy: a prospective, single-centre study

2020 ◽  
Author(s):  
Benedikt Zujalovic ◽  
Benjamin Mayer ◽  
Sebastian Hafner ◽  
Florian Balling ◽  
Eberhard Barth
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Repeated Measures ◽  
Acetylcholinesterase Activity ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Baseline Values

Abstract Background In consequence of systemic inflammation, up to 70% of septic patients develop a diffuse brain dysfunction, accompanying with an increase in mortality, which is referred to as “septic associated encephalopathy”. Subsuming septic associated encephalopathy as a category of delirium, there is a common pathophysiology (neuro-inflammation and cholinergic transmitter imbalance). This can be approximated by measuring the acetylcholinesterase activity as a surrogate parameter of cholinergic activity. However, conflicting results for acetylcholinesterase activity exists, if single-point measurements have been done. Therefore, we wanted to test the hypothesis, whether longitudinal analysis of acetylcholinesterase activity in Intensive Care Unit patients displays septic associated encephalopathy/delirium in septic patients and reveals significant differences in comparison with non-septic, critically ill patients.Methods In this prospective, observational, single-center study, 175 patients, admitted to the surgical Intensive Care Unit of the University hospital Ulm, Germany, were included. Patients were divided into septic (n = 45) and non-septic (n = 130) patients and were screened for delirium/cognitive dysfunction. Subgroups for patients with delirium and altered acetylcholinesterase activity were built, dependent if an increase/decrease of the acetylcholinesterase activity was observed. Acetylcholinesterase activity was analysed over the course of time by using a linear regression model accounting for repeated measures. By using a time adjusted model, the effect of further possible predictors of acetylcholinesterase activity was analyzed. For nonparametric distributions, quantitative data were compared using Wilcoxon matched-pairs test. For the analysis of the independent samples, we used the Mann-Whitney test. Results There was a statistically significant, time-dependent change in acetylcholinesterase activity (decrease/increase) over a period of at least 5 days in septic patients which revealed septic associated encephalopathy/delirium in about 90%.Conclusion The longitudinal measurement of acetylcholinesterase activity over several consecutive days revealed a shift compared to baseline values exclusively in septic patients with septic associated encephalopathy/delirium. Acetylcholinesterase activity alteration compared to baseline values at the onset of sepsis may help to detect and differentiate septic associated encephalopathy from other delirium entities.Trial registration Retrospectively registered at German Clincial Trials Register, registration number DRKS 00020542, date of registration: January 27, 2020

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