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An experienced physician knows how to recognize a patient suffering from sepsis, but cannot accurately determine whether the patient will survive. Cardinal elements of the treatment for sepsis include specific antibiotic and vasoactive drugs, enteral and parenteral nutrition, artificial respiration, and optimization of the oxygen transport to tissues. Nonetheless, with a certain frequency, these techniques are insufficient to ensure the recovery of a critically ill patient, especially when it is necessary to overcome functional alterations subsequent to organ and vital-system overload. The key elements in the progression of the sepsis-MODS syndrome are tied to numerous factors. These include: the severity and location of the lesion; the patient's age; the remaining functional reserve; the presence of mediatory which may be stimulatory, inhibitory or both.
List of contents
Sepsis and Organ Dysfunction. The Challenge Continues.- Oxygen Transport in Sepsis.- Biochemical Regulation of the Microcirculation.- Oxygen Supply and Consumption in Tissues.- Ischaemia-Reperfusion in Sepsis.- Mechanism of Oxygen Extraction Defect in Septic Shock.- Organ Dysfunction and Biohumoral Mismatch in Sepsis.- Gut Perfusion in Sepsis and Shock.- Pathophysiology of Encephalopathy.- Lung Dysfunction in the Early Phase of Sepsis.- The Kidney in Sepsis.- Pathophysiology of Liver Dysfunction in Sepsis.- Inflammatory Cells in Septic Shock.- Sepsis Trial.- Revised Terminology on Sepsis.- The Epidemiology and Outcome of Patients with Sepsis: Clear as Mud.- Are there Useful New Markers of Sepsis?.- A Paradigm Shift: The Bidirectional Effect of Inflammation on Bacterial Growth.- Is the Dosing and Timing of the Intervention Adequate?.- Clinical Trials of Mediator-Targeted Therapy in Sepsis.
