Sepsis: from bench to bedside

Authors

  • Eliézer Silva Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Research Division, Heart Institute
  • Rogério Da Hora Passos Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Research Division, Heart Institute
  • Maurício Beller Ferri Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Research Division, Heart Institute
  • Luiz Francisco Poli de Figueiredo Universidade de São Paulo; Faculdade de Medicina; Hospital das Clínicas; Research Division, Heart Institute

DOI:

https://doi.org/10.1590/S1807-59322008000100019

Keywords:

Sepsis, Shock, Infection, Organ Dysfunction, Organ Failure

Abstract

Sepsis is a syndrome related to severe infections. It is defined as the systemic host response to microorganisms in previously sterile tissues and is characterized by end-organ dysfunction away from the primary site of infection. The normal host response to infection is complex and aims to identify and control pathogen invasion, as well as to start immediate tissue repair. Both the cellular and humoral immune systems are activated, giving rise to both anti-inflammatory and proinflammatory responses. The chain of events that leads to sepsis is derived from the exacerbation of these mechanisms, promoting massive liberation of mediators and the progression of multiple organ dysfunction. Despite increasing knowledge about the pathophysiological pathways and processes involved in sepsis, morbidity and mortality remain unacceptably high. A large number of immunomodulatory agents have been studied in experimental and clinical settings in an attempt to find an efficacious anti-inflammatory drug that reduces mortality. Even though preclinical results had been promising, the vast majority of these trials actually showed little success in reducing the overwhelmingly high mortality rate of septic shock patients as compared with that of other critically ill intensive care unit patients. Clinical management usually begins with prompt recognition, determination of the probable infection site, early administration of antibiotics, and resuscitation protocols based on "early-goal" directed therapy. In this review, we address the research efforts that have been targeting risk factor identification, including genetics, pathophysiological mechanisms and strategies to recognize and treat these patients as early as possible.

Downloads

Download data is not yet available.

Downloads

Published

2008-01-01

Issue

Section

Review