Understanding Sepsis-associated Encephalopathy: New Insights into Mechanisms, Assessment, and Management – A Narrative Review

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Sepsis-associated encephalopathy (SAE) is a frequent and serious neurological complication of sepsis, characterized by diffuse cerebral dysfunction without direct infection of the central nervous system. It arises from a complex interplay of systemic inflammation, blood–brain barrier disruption, microcirculatory failure, and mitochondrial dysfunction. Clinically, SAE presents with altered consciousness, delirium, or coma and is strongly linked to higher mortality and long-term cognitive impairment. Early recognition through biomarkers, electroencephalography, and neuroimaging is crucial for timely management. Recent advances in molecular insights, machine learning prediction models, and precision medicine approaches offer promising directions for improving outcomes. This narrative review summarizes current mechanisms, assessment tools, and management strategies while highlighting future perspectives in diagnosis and neuroprotection.