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Revision as of 10:09, 25 July 2004 by Erich gasboy (talk | contribs) (update, correct, clarify)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff)Sepsis is a serious medical condition caused by severe systemic infection leading to a systemic inflammatory response. It has a mortality rate ranging from 28 to 50%.
The systemic inflammatory response syndrome leads to widespread activation of inflammation and coagulation pathways. This may progress to dysfunction of the circulatory system and, even under optimal treatment, multiple organ dysfunction syndrome and eventually death.
Sepsis is more common and also more dangerous in elderly, immunocompromised, and critically ill patients. It is a major cause of death in intensive care units worldwide. In the United States, sepsis is the leading cause of death in non-coronary ICU patients. It is the eleventh most common cause of death overall according to 1998 data from the Centers for Disease Control.
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 renal 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, 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 is still under investigation.
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.
- septic shock
- multiple organ dysfunction syndrome
References
- Bernard et al, NEJM 2001; 344:699-709