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Related Concept Videos

Asepsis01:28

Asepsis

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The condition of being free from disease-causing living pathogens is asepsis. Aseptic techniques include a set of standard practices to achieve asepsis. An example is the regular environmental cleaning of all parts of the healthcare facility and hand hygiene at home before preparing or eating food. Medical and surgical asepsis in healthcare practice protects patients from harmful pathogens, minimizes the risk of contamination of susceptible sites, and reduces the risk of infection transmission.
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Bacterial Meningitis II: Pathophysiology01:26

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Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
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General Anesthesia: Overview01:24

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Parenteral Anesthetics: Overview01:24

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Hand hygiene01:23

Hand hygiene

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Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
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Inhalational Anesthetics: Overview01:20

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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
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Sepsis pathophysiology and anesthetic consideration.

Koichi Yuki, Naoka Murakami1

  • 1Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts, 02115, USA.

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Summary

Sepsis poses a significant healthcare challenge. This review discusses the updated Surviving Sepsis Campaign guidelines and their application to anesthetic management, alongside advances in immune modulation for new sepsis therapies.

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Immunology

Background:

  • Sepsis is a major cause of mortality and high healthcare costs.
  • Understanding sepsis pathophysiology is crucial for effective treatment.
  • Current management emphasizes early goal-directed therapy.

Purpose of the Study:

  • To review the updated Surviving Sepsis Campaign 2012 guidelines.
  • To discuss the application of these guidelines to anesthetic management.
  • To explore recent advances in sepsis pathophysiology, particularly immune modulation.

Main Methods:

  • Review of the updated Surviving Sepsis Campaign 2012 guidelines.
  • Discussion of anesthetic management strategies for sepsis patients.
  • Review of recent research on sepsis pathophysiology and immune modulation.

Main Results:

  • The 2012 guidelines highlight the importance of early goal-directed therapy.
  • Anesthetic management can be adapted to incorporate guideline recommendations.
  • Advances in understanding immune modulation offer potential new therapeutic avenues.

Conclusions:

  • Early goal-directed therapy is critical in managing sepsis, including intraoperatively.
  • Anesthesiologists play a key role in implementing sepsis management guidelines.
  • Further research into immune modulation may yield novel treatments for sepsis.