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Sepsis and septic shock
G Zanetti1, J D Baumgartner, M P Glauser
1Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne.
Schweizerische Medizinische Wochenschrift
|March 22, 1997
Summary
Sepsis and septic shock are systemic infections with increasing incidence. Understanding their pathophysiology and bacterial triggers is key, but current therapies, including novel approaches, are not yet routinely applicable.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pathophysiology
Background:
- Focal infections can lead to systemic syndromes like sepsis, severe sepsis, and septic shock.
- The incidence of sepsis and septic shock has risen, with a stable ratio of gram-negative to gram-positive bacteria.
- Standardized definitions aid diagnosis but should complement clinical and microbiological assessments.
Purpose of the Study:
- To review the pathophysiology of sepsis and septic shock.
- To discuss current and emerging therapeutic strategies.
- To highlight the role of bacterial products in triggering inflammatory responses.
Main Methods:
- Literature review of sepsis pathophysiology and treatment.
- Analysis of trends in sepsis incidence and causative organisms.
- Discussion of molecular mechanisms involving bacterial products and host inflammatory responses.
Main Results:
- Bacterial products (lipopolysaccharide, exotoxins, cell wall fragments) directly trigger or stimulate cells to produce pro-inflammatory cytokines.
- Antibiotics and surgical intervention remain the cornerstone of sepsis management.
- Emerging therapies targeting inflammatory mediators have not yet yielded routine clinical applications.
Conclusions:
- Sepsis and septic shock result from complex inflammatory pathways initiated by infectious agents.
- While understanding has advanced, effective routine therapies beyond foundational treatments are still under development.
- Continued research into inhibiting inflammatory mediators is crucial for future sepsis management.