medigraphic.com

2008, Number 4

<< Back Next >>

Rev Hosp Jua Mex 2008; 75 (4)

Sepsis

Hernández LGD, Gutiérrez GCE, Reyes SG

Language: Spanish
References: 31
Page: 275-280
PDF size: 39.38 Kb.


ABSTRACT

Sepsis is a major cause of mortality in critically ill patients. Sepsis remains as the principal cause of death in critically ill patients. It is defined as the host response to infection. Cellular dysfunction in sepsis is the final outcome of a process with multiple stimuli. The transition from the systemic inflammatory response syndrome to severe sepsis and septic shock involves a diversity of pathogenic changes, including circulatory abnormalities that result in global tissue hypoxia. Clinical and laboratory signs of systemic inflammation including changes in body temperature, leukocytosis and tachycardia it is used for diagnosis of sepsis. However, they are neither specific nor sensitive for sepsis and can be misleading because critically ill patients often manifest a systemic inflammatory response syndrome (SIRS) without infection. Thus, diagnosis of sepsis is frequently difficult. Early identification of infection has a major impact on the clinical course, management, and outcome of critical patients. Many investigators have been finding, a reliable marker to discriminate the inflammatory response to infection from other types of inflammation. This syndrome should not be suspected, until than it is confirmed the microbiological origin. A marker that is able to distinguish the inflammatory response to infection from other types of inflammation would be of great clinical use. At present, directed therapy for the management of sepsis has shown decrease in mortality.


REFERENCES

  1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001; 29: 1303-10.

  2. Alberti C, Brun-Buisson C, Burchardi H, et al. Epidemiology of sepsis and infection in ICU patients from an international multicenter cohort study. Intensive Care Med 2002; 28: 108-21.

  3. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992; 20: 864-74.

  4. Levy M, Fink M, Marshall J, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 31: 1250-6.

  5. Landry D, Oliver J. The pathogenesis of Vasodilatory Shock. N Eng J Med 2001; 345: 588-95.

  6. Vallés J, Rello J, Ochagavía A, et al. Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. Chest 2003; 123: 1615-24.

  7. Hotchkiss R, Karl I. The Pathophysiology and Treatment of Sepsis. N Eng J Med 2003; 348: 138-50.

  8. Bochud P, Calandra T. Pathogenesis of sepsis: new concepts and implications for future treatment. Brit Med J 2003; 326: 262-6.

  9. Opal S, Huber CH. Bench-to-bedside review: Toll-like receptors and their role in septic shock. Critical Care Med 2002; 6: 125-36.

  10. Méndez-Beltrán M. Depresión miocárdica en sepsis. Rev Mex Anestesiol 2004; 27(Supl.1): 126-7.

  11. Calandra T, Cohen J. The International Sepsis Forum Consensus Conference on Definitions of Infection in the Intensive Care Unit. Crit Care Med 2005; 33: 1538-48.

  12. Bone R, Balk R, Cerra F, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101: 1644-55.

  13. Marshall JC, Ronald V, Jimenez M, et al. Source control in the management of severe sepsis and septic shock: An evidencebased review. Crit Care Med 2004; 32(Suppl.): S613-S626.

  14. Luzzani A, Polati E, Dorizzi R, et al. Comparison of procalcitonin and C-reactive protein as markers of sepsis. Crit Care Med 2003; 31: 1737-41.

  15. Young JD. The Heart and Circulation in Severe Sepsis. Br J Anaest 2004; 93: 114-20.

  16. Bleck TP, Smith MC, Pierre-Louis SJ, et al. Neurologic complications of critical medical illnesses. Crit Care Med 1993; 21: 98-103.

  17. Sharshar T, Hopkinson NS, Orlikowski D, et al. Science review: The brain in sepsis. Crit Care 2005; 9: 37-44.

  18. Schier RW, Wang W. Acute renal failure and sepsis. N Eng J Med 2004; 351: 159-69.

  19. Scherpereel A, Grigoriu B, Cavestri B, et al. Endocan, a new endothelial marker in human sepsis. Crit Care Med 2006; 34: 532-7.

  20. Rhodes A, Bennett ED. Early goal-directed therapy: An evidencebased review. Crit Care Med 2004; 32(Suppl.): S448-S450.

  21. Hollenberg SM, Ahrens TS, Annane D, Astiz ME, et al. Practice parameters for hemodynamic support of sepsis in adult patients. Crit Care Med 2004; 32: 1928-48.

  22. Vincent JL, Gerlach H. Fluid resuscitation in severe sepsis and septic shock: An evidence based review. Crit Care Med 2004; 32(Suppl.): S451-S453.

  23. Kollef MH. Inadequate antimicrobial treatment: an important determinant of outcome for hospitalized patients. Clin Infect Dis 2000; 31(Suppl. 4): S131-S138.

  24. Bochud PY, Bonten M, Marchetti O, et al. Antimicrobial therapy for patients with severe sepsis and septic shock: an evidence based-review. Crit Care Med 2004; 32(Suppl.): S495-S512.

  25. Dhainaut JF, Laterre PF, Janes JM, et al. Drotrecogin alfa (activated) in the treatment of severe sepsis patients with multiple organ dysfunction: data from the PROWESS trial. Intensive Care Med 2003; 29: 894-903.

  26. Fourrier F. Recombinant human activated protein C in the treatment of severe sepsis: An evidence-based review. Crit Care Med 2004; 32 (Suppl.): S534-S541.

  27. Annane D, Sebille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002; 288: 862-71.

  28. Minneci PC, Deans K, Banks S, et al. Meta analysis: The effect of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med 2004; 141: 47-56.

  29. Van Den Berghe G, Wouters PJ, Bouillon R, et al. Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control. Crit Care Med 2003; 31: 359-66.

  30. Cariou A, Vinsonneau C, Dhainaut JF. Adjunctive therapies in sepsis: An evidence-based review. Crit Care Med 2004; 32 (Suppl.): S562-S570.

  31. Krinsley JS. Effect of an Intensive Glucose Management Protocol on the Mortality of Critically Ill Adult Patients. Mayo Clin Proc 2004; 79: 992-1000.




2020     |     www.medigraphic.com