Impact on Cognitive Prognosis in Patients with Septic Encephalopathy related to Fluid Resuscitation: A Prospective Cohort Study

Objective Septic encephalopathy (SAE) is a common cerebral dysfunction associated with septic shock, which can lead to neurological and cognitive impairments. Early and adequate fluid resuscitation during septic shock not only reduces the risk of mortality but also significantly improves medium-to-long-term neurological outcomes for patients with SAE. This study investigated the relationship between fluid resuscitation and cognitive prognosis in SAE patients via TCD(Transcranial Doppler ultrasonography), with implications for early intervention. Methods In this prospective cohort study, 150 patients with septic shock were enrolled and categorised into SAE and non-SAE groups on the basis of clinical diagnostic criteria. SAE patients received standardised fluid resuscitation and were stratified into successful resuscitation and unsuccessful resuscitation subgroups. TCD was performed 24 hours, 48 hours, 1 week, and 2 weeks after admission to evaluate cerebral perfusion. Cognitive function was assessed on day 30 using the Mini-Mental State Examination (MMSE). Results TCD effectively identified SAE in septic shock patients. Significant differences in TCD-negative detection rates were observed between the successful and unsuccessful resuscitation subgroups at 48 hours, 1 week, and 2 weeks (p < 0.05). Statistically distinct MMSE scores were also noted at the 30-day follow-up. Conclusion Effective fluid resuscitation in septic shock patients has positive implications for neurological recovery and medium-to-long-term cognitive improvement. TCD exhibits favourable efficacy and operational feasibility in the evaluation of neurological outcomes for prognostic purposes, thus supporting its integration into clinical decision-making protocols.