SEPSIS – A GLOBAL MEDICAL PROBLEM IN MODERN INTENSIVE CARE
Keywords:
Sepsis, septic shock, multi-organ failure, cytokine storm, SOFA, intensive care, vasopressors.Abstract
Sepsis is a severe pathological condition that develops as a result of an unbalanced response of the body to infection, accompanied by life-threatening multi-organ failure. In modern medicine, sepsis is one of the most urgent problems in intensive care and resuscitation practice. According to the World Health Organization, millions of patients die from sepsis every year worldwide. The pathogenesis of sepsis is based on the cytokine cascade, endothelial dysfunction, microcirculation disorders and tissue hypoxia. Early diagnosis (SOFA, qSOFA criteria) and intensive care initiated within the “first hour” significantly reduce mortality. This article discusses the etiology, pathogenesis, clinical signs and principles of modern treatment of sepsis on a scientific basis.
References
1. Evans L., Rhodes A., Alhazzani W. Et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Medicine, 2021.
2. Rhodes A., Evans L.E., Alhazzani W. Surviving Sepsis Campaign Guidelines 2021: Executive Summary. Critical Care Medicine, 2021.
3. (based on the recommendations of the Surviving Sepsis Campaign)
4. Rudd KE, Johnson SC, Agesa KM. Et al. Global burden of sepsis: a systematic analysis. The Lancet, 2020.
5. Singer M., Deutschman C.S., Seymour C.W. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, updated analysis 2020–2022.
6. Cecconi M., Evans L., Levy M., Rhodes A. Sepsis and septic shock. The Lancet, 2022.
7. Vincent J.L., Sakr Y., Sprung C.L. Sepsis in intensive care units: epidemiology and outcomes. Critical Care, 2023.
8. Fleischmann-Struzek C., Mellhammar L., Rose N. Et al. Incidence and mortality of hospital-treated sepsis. Intensive Care Medicine, 2023.
9. Hotchkiss RS, Moldawer LL, Opal SM. Immunosuppression in sepsis: mechanisms and therapeutic implications. Nature Reviews Immunology, 2020.
10. Van der Poll T., Shankar-Hari M., Wiersinga W.J. The immunology of sepsis. Immunity, 2021.
11. World Health Organization. Global report on the epidemiology and burden of sepsis. 2023.
12. World Health Organization
13. Levy M.M., Evans L.E., Rhodes A. The Surviving Sepsis Campaign Bundle: 2021 update. Intensive Care Medicine, 2021.
14. Reinhart K., Daniels R., Kissoon N. Recognizing Sepsis as a Global Health Priority. New England Journal of Medicine, 2022.
15. Bauer M., Gerlach H., Vogelmann T. Mortality in sepsis and septic shock in Europe. Intensive Care Medicine, 2023.
16. Prescott H.C., Angus D.C. Enhancing Recovery From Sepsis. JAMA, 2022.
17. Liu WH, Fielding-Singh W, Greene JD. The timing of early antibiotics and hospital mortality in sepsis. American Journal of Respiratory and Critical Care Medicine, 2021.