[Sepsis and multiple organ dysfunctions--pathophysiology and the topical concepts of treatment].
Severe sepsis with multiple organ dysfunctions is still the leading cause of death in non-cardiac intensive care units (ICU). The incidence is expected to rise in the future due to the growing number of older and immunocompromized patients, the use of invasive procedures, and an increase in the percentage of aggressive or resistant microorganisms. Despite the enormous investment in critical care resources, severe sepsis mortality remains to be high and ranges from 28 to 50%. Based on the disappointing experiences with anti-inflammatory strategies, the authors now realize that sepsis is more than just an inflammation. By taking into account pathophysiological changes, the new therapeutic concepts combine successful modulation with an improvement of the ICU management of multiple organ dysfunctions. This review discusses the actual sepsis intensive care concepts that may be useful in reducing unacceptable high mortality rates in patients with severe sepsis.
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V
Winter
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E
Czeslick
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A
Sablotzki
D006801:Humans; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy*