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The systemic inflammatory response syndrome.

Markus A Weigand1, Christian Hörner, Hubert J Bardenheuer

  • 1Department of Anesthesia, University of Heidelberg, Im Neuenheimer Feld 110, Heidelberg 69120, Germany. markus_weigand@med.uni-heidelberg.de

Best Practice & Research. Clinical Anaesthesiology
|June 24, 2004
PubMed
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Sepsis, a critical condition causing organ failure and death, involves inflammatory responses and coagulation. Current treatments focus on infection control and supportive care, with emerging therapies targeting specific inflammatory pathways.

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Pathophysiology

Background:

  • Sepsis and septic shock are leading causes of intensive care unit mortality.
  • Sepsis involves a systemic inflammatory response to infection, leading to hypoperfusion, tissue injury, and organ failure.
  • Monocyte/macrophage and neutrophil activation, pro-inflammatory mediator release, and coagulation cascade activation are key in sepsis pathogenesis.

Purpose of the Study:

  • To review the pathogenesis and current therapeutic strategies for sepsis.
  • To highlight adjunctive therapies and promising experimental treatments for sepsis.

Main Methods:

  • Literature review of sepsis pathogenesis and treatment strategies.
  • Discussion of established and experimental therapeutic interventions.

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Main Results:

  • Standard sepsis therapy includes eliminating the septic focus, antimicrobial treatment, and supportive care.
  • Adjunctive therapies like low-dose hydrocortisone for refractory septic shock and activated protein C for septic multiple organ failure are discussed.
  • Experimental treatments targeting MIF, HMGB1, C5a, TREM-1 signaling, and apoptosis inhibition show future promise.

Conclusions:

  • Sepsis remains a significant challenge in critical care despite medical advances.
  • Current management relies on foundational treatments, with adjunctive and experimental therapies offering potential improvements.
  • Future research into novel signaling pathways and apoptosis inhibition may enhance sepsis patient outcomes.