Which of the following is a set of clinical factors that increase delirium risk?

• A. Hypotension
• B. Infection/sepsis, anemia, acidosis, and hypotension
• C. Normal perfusion
• D. Adequate oxygenation

Answer: (B)

Delirium in critically ill patients is driven by systemic stresses that disrupt brain function. Infection or sepsis triggers inflammatory pathways that affect the brain and can alter neurotransmission, increasing delirium risk. Anemia lowers the blood’s oxygen-carrying capacity, so cerebral oxygen delivery drops, especially during illness. Acidosis disturbs neuronal function and neurotransmitter balance, making the brain more prone to confusion. Hypotension reduces cerebral perfusion, compounding oxygen delivery problems and metabolic stress in neural tissue. When these factors occur together, the brain is subjected to inflammation, hypoxia, metabolic disturbance, and reduced blood flow, all of which strongly predispose to delirium.

Choices that point to normal perfusion or adequate oxygenation imply protective conditions, and a single factor like hypotension, while risky, doesn’t capture the broader set of systemic insults that collectively raise delirium risk.