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'''Sepsis''' is a serious medical condition caused by severe systemic ] leading to a ]. It has a mortality rate ranging from 28 to 50%.
⚫ ]


'''Sepsis''' is a life-threatening condition caused by the ] of an organism to severe ]. Sepsis is characterized by overwhelming systemic (i.e. not localised) ]. It is often associated with ] disorders and dysfunction of the ]. Even under optimal treatment, dysfunction of many organ systems may progress to multiple organ failure and eventually death. The systemic inflammatory response syndrome leads to widespread activation of ] and ] pathways. This may progress to dysfunction of the ] and, even under optimal treatment, ] and eventually death.


Sepsis is particulary common and dangerous in elderly, immunocompromised, and critically ill patients, where it is a major cause of death in intensive care units worldwide. In the ], sepsis is the leading cause of death in non-] ] patients, while recent 1998 data from the ] show that it is the 11th leading cause of death overall. Mortality rates ranging from 28 to 50% have been reported for sepsis. Sepsis is more common and also more dangerous in elderly, immunocompromised, and critically ill patients. It is a major cause of death in ]s worldwide. In the ], sepsis is the leading cause of death in non-] ] patients. It is the eleventh most common cause of death overall according to 1998 data from the ].


==Treatment==
The therapy of sepsis rests on ] (and in some cases, surgical) treatment of the causating infection, fluid replacement, adequate nutrition (including ]), and appropriate support for organ dysfunction. This may include ] in renal failure, ] in pulmonary dysfunction, transfusion of ], ] and coagulation factors to stabilize blood ], and drug and fluid therapy for circulatory failure. Therapeutic strategies aimed at the inflammation process itself have largely failed to improve outcome. However, the infusion of activated Protein C, a coagulation factor, has recently been shown to improve survival in sepsis. Low dose ] also seems to be beneficial. The therapy of sepsis rests on ]s, surgical drainage of infected fluid collections, fluid replacement and appropriate support for organ dysfunction. This may include ] in renal failure, ] in pulmonary dysfunction, transfusion of ], ] and coagulation factors to stabilize blood ], and drug and fluid therapy for circulatory failure. Ensuring adequate nutrition, if necessary by ], is important during prolonged illness.


Most therapies aimed at the inflammatory process itself have failed to improve outcome. However, ], one of the ]s, has been shown to decrease mortality from about 31% to about 25% in severe sepsis (Bernard et al, 2001). Low dose ] treatment is still under investigation.


==Related conditions== ==Related conditions==
* ] is an inflammatory response to a ], or the invasion of normally sterile host tissues by the organism.
*'''Septicemia''' (or ''']''') is the presence of ] in the ]. Septicemia can occur in sepsis and other serious diseases such as infective ], but it may also be a harmless and transient condition. * ] is the presence of ] in the ]. Bacteraemia can occur in sepsis and other serious diseases such as infective ], but it may also be a harmless and transient condition.
*]
*] * ]
* ]

==References==
# Bernard et al, NEJM 2001; 344:699-709


] ]
⚫ ]
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Revision as of 10:09, 25 July 2004

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

References

  1. Bernard et al, NEJM 2001; 344:699-709
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