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Revision as of 11:27, 30 May 2005 by 81.77.37.96 (talk) (→Symptoms)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition caused by a severe systemic infection leading to a systemic inflammatory response. The more critical subsets of sepsis include severe sepsis (sepsis with acute organ dysfunction) and septic shock (sepsis with refractory arterial hypotension).
Septicemia is sepsis of the bloodstream caused by bacteremia, which is the presence of bacteria in the bloodstream. The term septicemia is also used to refer to sepsis in general.
Symptoms
The systemic
Treatment
The therapy of sepsis rests on antibiotics, surgical drainage of infected fluid collections, fluid replacement and appropriate support for organ dysfunction. This may include hemodialysis in kidney failure, mechanical ventilation in pulmonary dysfunction, transfusion of blood plasma, platelets and coagulation factors to stabilize blood coagulation, and drug and fluid therapy for circulatory failure. Ensuring adequate nutrition, if necessary by parenteral nutrition, is important during prolonged illness.
Most therapies aimed at the inflammatory process itself have failed to improve outcome. However, drotrecogin (activated protein C, one of the coagulation factors) has been shown to decrease mortality from about 31% to about 25% in severe sepsis (Bernard et al 2001). Low dose cortisol treatment has shown promise for septic shock patients with relative adrenal insufficiency.
Related conditions
- infection is an inflammatory response to a microorganism, or the invasion of normally sterile host tissues by the organism.
- bacteraemia is the presence of bacteria in the blood. Bacteraemia can occur in sepsis and other serious diseases such as infective endocarditis, but it may also be a harmless and transient condition.
- diffuse intravascular coagulation (DIC)
- multiple organ dysfunction syndrome
References
- Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, Fisher CJ Jr; Recombinant human protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study group. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699-709. PMID 11236773
- Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, Ramsay G, Zimmerman JL, Vincent JL, Levy MM; Surviving Sepsis Campaign Management Guidelines Committee. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004;32:858-73. PMID 15090974.
- Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-54. PMID 12700374