Sepsis and organ dysfunction/failure. An overview.
Sepsis is a condition at high risk for the patients to develop organ(s) or system dysfunction/failure and represent a very limiting process for survival. Researchers and clinicians proposed standardization of terminology for sepsis and related problems to improve communication and to evaluate the efficacy of preventive measures and therapeutic interventions. Interrelationship among systemic inflammatory response syndrome (SIRS), infection and sepsis are surrounded by non infectious satellite events such as trauma, burns, pancreatitis, haemorrhagic shock, immune-mediated organ injury and infectious cause such as fungemia, parasitemia, viremia. The prevalence of infections among intensive care patients has been reported to vary from 15 to 40%. Usually indicators of sepsis are persistent hyperlactatemia and supranormal level of DO2. These conditions may progress as a sort of dynamic process known as endotoxaemia condition which is mediated by derangement of biohumoral factors inducing immunological dissonance and ultimately concomitant or sequential organs dysfunction/failure. Multiple sources of sepsis is a phenomenon clearly associated with poor prognosis and all the sepsis trials managed in the last decades have failed on reducing mortality rate in enrolled patients. Development of scoring system routinely used at bedside represent an important method to establish cost-effectiveness in this exiting area of study and clinical management. Controversial results on sepsis need a sort of consensus at different level from researchers to clinician experiencing new strategies for prevention and more appropriately therapeutic approach for the management of this syndrome.
Gullo
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Department of Anaesthesia and Intensive Care, University School of Medicine, Trieste, Italy.
D006801:Humans; D009102:Multiple Organ Failure / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D018805:Sepsis / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy