The pathogenesis of sepsis
Article Abstract:
Severe infection, often with evidence of the infecting organism travelling throughout the bloodstream, results in a disease state known as sepsis. Sepsis can produce shock, in which the blood pressure is too low to provide the organs with an adequate blood supply; sepsis with shock often causes death. People with pre-existing disease, such as cancer, cirrhosis, and significant heart disease, seem to be most prone to progressing to shock and death. The substances in the bloodstream that sepsis produces have been the focus of much research. Some of the substances identified thus far are known as mediators, and include tumor necrosis factor, the interleukins, leukotrienes, and a group of immune proteins collectively known as complement. None of these appears to be the prime mediator of sepsis. Instead, they seem to act in concert to produce damage. Much of this damage results from the action of the mediators on the cells lining the blood vessels. When the cells of capillaries, the small blood vessels that serve as the main suppliers of blood to the various organs, are damaged, the organs they supply are damaged, leading to a condition called multisystem failure. An example of this is an individual with sepsis and septic shock who experiences kidney and liver damage; without adequate treatment of the source of the sepsis and its sequelae, death may ensue. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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Sepsis, the sepsis syndrome, multi-organ failure: a plea for comparable definitions
Article Abstract:
A number of terms are used in the literature and in clinical settings to describe the phenomenon of severe infection. Because of this confusion, patients may be treated according to inappropriate protocols and incomparable conditions may be considered in testing a hypothesis. A proposal is made for uniformity in these terms. Bacteremia is a term that refers to the presence of living bacteria circulating in the bloodstream, and is diagnosed by culturing the blood and identifying those microorganisms. Septicemia has been used in the past to describe both bloodborne infection and the effect of toxins produced by microorganisms, and is no longer a useful term. Sepsis should be defined as the clinical evidence of infection, with a rapid respiratory rate, rapid heartbeat, and abnormally high or low body temperature. The sepsis syndrome should be defined as sepsis with evidence of impaired circulation to various organs. Septic shock should refer to the sepsis syndrome with an abnormally low blood pressure. Refractory shock should be used to describe septic shock that does not respond to treatment within one hour. Use of precise terms may simplify research, lead to more timely patient care, and improve treatment outcomes of these syndromes. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS)
Article Abstract:
Immunologic dissonance between proinflammatory and anti-inflammatory forces may be a better way of defining what causes sepsis and multiple organ dysfunction. A better term for sepsis may be systemic inflammatory response syndrome (SIRS), and multiple organ dysfunction syndrome (MODS) should replace the term multiple organ failure as it describes the process of organ dysfunction. Proinflammatory and anti-inflammatory forces within the body may normally balance each other without causing negative effects. Imbalanced inflammatory forces may produce shock, lack of blood coagulation, and fluid buildup in organs. Such an understanding may improve treatment of massive inflammation.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1996
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