{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:54:26Z","timestamp":1791971666668,"version":"4.3.4"},"reference-count":55,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Annals of Intensive Care"],"published-print":{"date-parts":[[2026]]},"DOI":"10.1016\/j.aicoj.2026.100033","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T18:01:30Z","timestamp":1771437690000},"page":"100033","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Severe hypotension but not systemic inflammation or endothelial activation predicts encephalopathy in circulatory shock"],"prefix":"10.1016","volume":"16","author":[{"given":"Duc Nam","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Huyghens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truc Mai","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Schiettecatte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Diltoer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Cools","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"De Cuyper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rhapsorski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Smitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"7","key":"10.1016\/j.aicoj.2026.100033_bib0005","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.7150\/ijbs.102234","article-title":"Sepsis-associated encephalopathy: mechanisms, diagnosis, and treatments update","volume":"21","author":"Li","year":"2025","journal-title":"Int J Biol Sci."},{"issue":"8","key":"10.1016\/j.aicoj.2026.100033_bib0010","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0200495","article-title":"Hypotension and a positive fluid balance are associated with delirium in patients with shock","volume":"13","author":"Nguyen","year":"2018","journal-title":"PLoS One."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0015","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s12974-022-02464-4","article-title":"Sepsis-associated brain injury: underlying mechanisms and potential therapeutic strategies for acute and long-term cognitive impairments","volume":"19","author":"Sekino","year":"2022","journal-title":"J Neuroinflammation."},{"issue":"6","key":"10.1016\/j.aicoj.2026.100033_bib0020","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1007\/s10753-021-01501-3","article-title":"Sepsis-associated encephalopathy and blood-brain barrier dysfunction","volume":"44","author":"Gao","year":"2021","journal-title":"Inflammation."},{"key":"10.1016\/j.aicoj.2026.100033_bib0025","article-title":"The role of the peripheral system dysfunction in the pathogenesis of sepsis-associated encephalopathy","volume":"15","author":"Zhang","year":"2024","journal-title":"Front Microbiol."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0030","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1007\/s12035-022-03148-z","article-title":"The key drivers of brain injury by systemic inflammatory responses after sepsis: microglia and neuroinflammation","volume":"60","author":"Xin","year":"2023","journal-title":"Mol Neurobiol."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0035","doi-asserted-by":"crossref","first-page":"e241","DOI":"10.1097\/CCM.0000000000005307","article-title":"Postmortem evidence of brain inflammatory markers and injury in septic patients: a systematic review","volume":"50","author":"Barichello","year":"2022","journal-title":"Crit Care Med."},{"issue":"15","key":"10.1016\/j.aicoj.2026.100033_bib0040","article-title":"Effect of systemic inflammation in the CNS: a silent history of neuronal damage","volume":"24","author":"Solano","year":"2023","journal-title":"Int J Mol Sci."},{"key":"10.1016\/j.aicoj.2026.100033_bib0045","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2023.1217965","article-title":"Prognostic significance of delirium in patients with heart failure: a systematic review and meta-analysis","volume":"10","author":"Niu","year":"2023","journal-title":"Front Cardiovasc Med."},{"issue":"5","key":"10.1016\/j.aicoj.2026.100033_bib0050","first-page":"306","article-title":"Inflammatory response by 48 h after admission and mortality in patients with acute myocardial infarction complicated by cardiogenic shock","volume":"12","author":"Kunkel","year":"2023","journal-title":"Eur Heart J Acute Cardiovasc Care."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0055","first-page":"38","article-title":"Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study","volume":"7","author":"Kataja","year":"2018","journal-title":"Eur Heart J Acute Cardiovasc Care."},{"issue":"12","key":"10.1016\/j.aicoj.2026.100033_bib0060","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines12122864","article-title":"Navigating hemorrhagic shock: biomarkers, therapies, and challenges in clinical care","volume":"12","author":"Meza Monge","year":"2024","journal-title":"Biomedicines."},{"issue":"5","key":"10.1016\/j.aicoj.2026.100033_bib0065","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s00134-024-07388-6","article-title":"Systemic inflammation and delirium during critical illness","volume":"50","author":"Brummel","year":"2024","journal-title":"Intensive Care Med."},{"issue":"12","key":"10.1016\/j.aicoj.2026.100033_bib0070","doi-asserted-by":"crossref","DOI":"10.1007\/s00134-012-2678-x","article-title":"Associations of markers of inflammation and coagulation with delirium during critical illness","volume":"38","author":"Girard","year":"2012","journal-title":"Intensive Care Med."},{"key":"10.1016\/j.aicoj.2026.100033_bib0075","article-title":"MARS consortium. Biomarker patterns in patients with cardiogenic shock versus septic shock","volume":"52","author":"Peters","year":"2024","journal-title":"Int J Cardiol Heart Vasc."},{"issue":"2","key":"10.1016\/j.aicoj.2026.100033_bib0080","doi-asserted-by":"crossref","DOI":"10.1186\/cc10070","article-title":"Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients","volume":"15","author":"McGrane","year":"2011","journal-title":"Crit Care."},{"issue":"2","key":"10.1016\/j.aicoj.2026.100033_bib0085","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/SHK.0b013e31821e4e04","article-title":"Endothelial cell activation in emergency department patients with sepsis-related and non-sepsis-related hypotension","volume":"36","author":"Schuetz","year":"2011","journal-title":"Shock."},{"issue":"4","key":"10.1016\/j.aicoj.2026.100033_bib0090","doi-asserted-by":"crossref","first-page":"127","DOI":"10.31083\/ph.2021.1315","article-title":"The role of vascular endothelial growth factor in ischemic stroke","volume":"76","author":"Chen","year":"2021","journal-title":"Pharmazie."},{"key":"10.1016\/j.aicoj.2026.100033_bib0095","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2022.941257","article-title":"Prognostic role of elevated VEGF in sepsis: a systematic review and meta-analysis","volume":"13","author":"Tang","year":"2022","journal-title":"Front Physiol."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0100","doi-asserted-by":"crossref","first-page":"647","DOI":"10.14336\/AD.2021.1121","article-title":"VEGF, a key factor for blood brain barrier injury after cerebral ischemic stroke","volume":"13","author":"Hu","year":"2022","journal-title":"Aging Dis."},{"key":"10.1016\/j.aicoj.2026.100033_bib0105","article-title":"Serum ICAM-1 as a predictor of prognosis in patients with acute ischemic stroke","volume":"2021","author":"Wang","year":"2021","journal-title":"Biomed Res Int."},{"issue":"4-6","key":"10.1016\/j.aicoj.2026.100033_bib0110","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1159\/000500068","article-title":"Soluble intercellular adhesion molecule-1 (sICAM-1) as a biomarker of vascular cognitive impairment in older adults","volume":"47","author":"Gregory","year":"2019","journal-title":"Dement Geriatr Cogn Disord."},{"issue":"2","key":"10.1016\/j.aicoj.2026.100033_bib0115","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0281941","article-title":"Endothelial glycocalyx-associated molecules as potential serological markers for sepsis-associated encephalopathy: a systematic review and meta-analysis","volume":"18","author":"Baby","year":"2023","journal-title":"PLoS One."},{"key":"10.1016\/j.aicoj.2026.100033_bib0120","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/598762","article-title":"Elevated serum vascular cell adhesion molecule-1 is associated with septic encephalopathy in adult community-onset severe sepsis patients","author":"Su","year":"2014","journal-title":"Biomed Res Int."},{"key":"10.1016\/j.aicoj.2026.100033_bib0125","article-title":"Diagnostic and prognostic value of serum S100B in sepsis-associated encephalopathy: a systematic review and meta-analysis","volume":"14","author":"Hu","year":"2023","journal-title":"Front Immunol."},{"issue":"22","key":"10.1016\/j.aicoj.2026.100033_bib0130","first-page":"2109","article-title":"How S100B crosses brain barriers and why it is considered a peripheral marker of brain injury","volume":"248","author":"Gayger-Dias","year":"2023","journal-title":"Exp Biol Med (Maywood)."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0135","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/CCM.0000000000004139","article-title":"Biomarkers of delirium duration and delirium severity in the ICU","volume":"48","author":"Khan","year":"2020","journal-title":"Crit Care Med"},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0140","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med."},{"issue":"23","key":"10.1016\/j.aicoj.2026.100033_bib0145","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.032748","article-title":"Serial assessment of shock severity in cardiac intensive care unit patients","volume":"12","author":"Jentzer","year":"2023","journal-title":"J Am Heart Assoc."},{"issue":"10466","key":"10.1016\/j.aicoj.2026.100033_bib0150","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1016\/S0140-6736(24)01818-X","article-title":"Cardiogenic shock","volume":"404","author":"L\u00fcsebrink","year":"2024","journal-title":"Lancet"},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0155","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40560-024-00773-9","article-title":"Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening-an analysis of the OUTCOMEREA database","volume":"13","author":"Thy","year":"2025","journal-title":"J Intensive Care."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0160","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13613-019-0528-5","article-title":"Effects of mean arterial pressure on arousal in sedated ventilated patients with septic shock: a SEPSISPAM post hoc exploratory study","volume":"9","author":"Jouan","year":"2019","journal-title":"Ann Intensive Care"},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0165","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1186\/s13054-018-2258-8","article-title":"Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis","volume":"22","author":"Crippa","year":"2018","journal-title":"Crit Care"},{"issue":"6","key":"10.1016\/j.aicoj.2026.100033_bib0170","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.bja.2024.01.043","article-title":"Monitoring of cerebral blood flow autoregulation: physiologic basis, measurement, and clinical implications","volume":"132","author":"Vu","year":"2024","journal-title":"Br J Anaesth"},{"issue":"9","key":"10.1016\/j.aicoj.2026.100033_bib0175","doi-asserted-by":"crossref","first-page":"814","DOI":"10.23736\/S0375-9393.24.17978-3","article-title":"Brain hemodynamics in septic patients","volume":"90","author":"Crippa","year":"2024","journal-title":"Minerva Anestesiol."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0180","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/CCM.0000000000006096","article-title":"In-hospital neurologic complications, neuromonitoring, and long-term neurologic outcomes in patients with sepsis: a systematic review and meta-analysis","volume":"52","author":"Fan","year":"2024","journal-title":"Crit Care Med"},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0185","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s13054-023-04655-8","article-title":"The spectrum of sepsis-associated encephalopathy: a clinical perspective","volume":"27","author":"Sonneville","year":"2023","journal-title":"Crit Care."},{"key":"10.1016\/j.aicoj.2026.100033_bib0190","doi-asserted-by":"crossref","DOI":"10.1186\/cc12899","article-title":"Pattern of brain injury in the acute setting of human septic shock","volume":"17","author":"Polito","year":"2013","journal-title":"Crit Care"},{"key":"10.1016\/j.aicoj.2026.100033_bib0195","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1097\/CCM.0000000000003924","article-title":"Association between sepsis and microvascular brain injury","volume":"47","author":"Ehlenbach","year":"2019","journal-title":"Crit Care Med"},{"key":"10.1016\/j.aicoj.2026.100033_bib0200","doi-asserted-by":"crossref","DOI":"10.1186\/cc6891","article-title":"Cerebral perfusion in sepsis-associated delirium","volume":"12","author":"Pfister","year":"2008","journal-title":"Crit Care"},{"key":"10.1016\/j.aicoj.2026.100033_bib0205","doi-asserted-by":"crossref","first-page":"e663","DOI":"10.1097\/CCM.0000000000003147","article-title":"Early evidence of sepsis-associated hyperperfusion-A study of cerebral blood flow measured with MRI arterial spin labelling in critically ill septic patients and control subjects","volume":"46","author":"Masse","year":"2018","journal-title":"Crit Care Med"},{"issue":"2","key":"10.1016\/j.aicoj.2026.100033_bib0210","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1007\/s12028-024-02117-9","article-title":"Alterations in regional brain microcirculation in patients with sepsis: a prospective study using contrast-enhanced brain ultrasound","volume":"42","author":"Nguyen","year":"2025","journal-title":"Neurocrit Care"},{"issue":"7","key":"10.1016\/j.aicoj.2026.100033_bib0215","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1038\/s41577-021-00643-7","article-title":"Cerebral dysfunctions caused by sepsis during ageing","volume":"22","author":"Manabe","year":"2022","journal-title":"Nat Rev Immunol."},{"key":"10.1016\/j.aicoj.2026.100033_bib0220","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpsychores.2021.110530","article-title":"Biomarkers in delirium: a systematic review","volume":"147","author":"Dunne","year":"2021","journal-title":"J Psychosom Res."},{"issue":"6","key":"10.1016\/j.aicoj.2026.100033_bib0225","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1055\/s-0044-1791666","article-title":"The pathophysiology and biomarkers of delirium","volume":"44","author":"Smith","year":"2024","journal-title":"Semin Neurol."},{"key":"10.1016\/j.aicoj.2026.100033_bib0230","article-title":"Inflammatory biomarkers and delirium: a Mendelian randomization study","volume":"15","author":"Miao","year":"2023","journal-title":"Front Aging Neurosci."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0235","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-023-32070-0","article-title":"Brain injury biomarkers do not predict delirium in acutely ill older patients: a prospective cohort study","volume":"13","author":"de Alencar","year":"2023","journal-title":"Sci Rep."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0240","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13613-019-0548-1","article-title":"Serum biomarkers of delirium in the elderly: a narrative review","volume":"9","author":"Toft","year":"2019","journal-title":"Ann Intensive Care."},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0245","article-title":"Microglial activation and neuroinflammation in acute and chronic cognitive deficits in sepsis","volume":"267","author":"Denver","year":"2025","journal-title":"Neuropharmacology"},{"issue":"9","key":"10.1016\/j.aicoj.2026.100033_bib0250","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0290298","article-title":"Association between change in the peripheral biomarkers of inflammation, astrocyte activation, and neuroprotection at one week of critical illness and hospital mortality in patients with delirium: a prospective cohort study","volume":"18","author":"Khan","year":"2023","journal-title":"PLoS One."},{"key":"10.1016\/j.aicoj.2026.100033_bib0255","doi-asserted-by":"crossref","DOI":"10.3389\/fncel.2023.1238149","article-title":"Septic encephalopathy in the elderly - biomarkers of potential clinical utility","volume":"17","author":"Sch\u00fctze","year":"2023","journal-title":"Front Cell Neurosci"},{"issue":"1","key":"10.1016\/j.aicoj.2026.100033_bib0260","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s40560-023-00676-1","article-title":"Organ dysfunction, injury, and failure in cardiogenic shock","volume":"11","author":"Shirakabe","year":"2023","journal-title":"J Intensive Care."},{"issue":"2","key":"10.1016\/j.aicoj.2026.100033_bib0265","doi-asserted-by":"crossref","first-page":"e400","DOI":"10.1097\/CCM.0000000000006520","article-title":"Prognostic factors associated with intracranial hemorrhage and ischemic stroke during veno venous extracorporeal membrane oxygenation: a systematic review","volume":"53","author":"Thiara","year":"2025","journal-title":"Crit Care Med."},{"issue":"3","key":"10.1016\/j.aicoj.2026.100033_bib0270","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1177\/0885066621997090","article-title":"The use of near-infrared spectroscopy and\/or transcranial doppler as non-invasive markers of cerebral perfusion in adult sepsis patients with delirium: a systematic review","volume":"37","author":"Wood","year":"2022","journal-title":"J Intensive Care Med"},{"issue":"12","key":"10.1016\/j.aicoj.2026.100033_bib0275","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1177\/0885066619828293","article-title":"Cerebral autoregulation-guided optimal blood pressure in sepsis-associated encephalopathy: a case series","volume":"35","author":"Rosenblatt","year":"2020","journal-title":"J Intensive Care Med"}],"container-title":["Annals of Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2110582026000099?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2110582026000099?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:33:15Z","timestamp":1791970395000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2110582026000099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":55,"alternative-id":["S2110582026000099"],"URL":"https:\/\/doi.org\/10.1016\/j.aicoj.2026.100033","relation":{},"ISSN":["2110-5820"],"issn-type":[{"value":"2110-5820","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Severe hypotension but not systemic inflammation or endothelial activation predicts encephalopathy in circulatory shock","name":"articletitle","label":"Article Title"},{"value":"Annals of Intensive Care","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.aicoj.2026.100033","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Masson SAS on behalf of Soci\u00e9t\u00e9 de R\u00e9animation de Langue Fran\u00e7aise (French Intensive Care Society).","name":"copyright","label":"Copyright"}],"article-number":"100033"}}