User:Mr. Ibrahem/Sepsis

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For the type of flies, see Sepsis (fly).
Sepsis
Other namesSepticemia, blood poisoning
Blood culture bottles: orange cap for anaerobes, green cap for aerobes, and yellow cap for blood samples from children[1]
Pronunciation
SpecialtyInfectious disease
SymptomsFever, increased heart rate, low blood pressure, increased breathing rate, confusion[2]
CausesImmune response triggered by an infection[3][4]
Risk factorsYoung or old age, cancer, diabetes, major trauma, burns[2]
Diagnostic methodSystemic inflammatory response syndrome (SIRS),[3] qSOFA[5]
TreatmentIntravenous fluids, antimicrobials[2][6]
Prognosis10 to 80% risk of death[5][7]
Frequency0.2–3 per 1000 a year (developed world)[7][8]

Sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its tissues and organs.[5] This initial stage is followed by suppression of the immune system.[9] Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion.[2] There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection.[3] The very young, old, and people with a weakened immune system may have no symptoms of a specific infection, and the body temperature may be low or normal instead of having a fever.[3] Severe sepsis is sepsis causing poor organ function or blood flow.[10] The presence of low blood pressure, high blood lactate, or low urine output may suggest poor blood flow.[10] Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement.[10]

Sepsis is an inflammatory immune response triggered by an infection.[3][4] Bacterial infections are the most common cause, but fungal, viral, and protozoan infections can also lead to sepsis.[3] Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs.[3] Risk factors include being very young, older age, a weakened immune system from conditions such as cancer or diabetes, major trauma, or burns.[2] Previously, a sepsis diagnosis required the presence of at least two systemic inflammatory response syndrome (SIRS) criteria in the setting of presumed infection.[3] In 2016, a shortened sequential organ failure assessment score (SOFA score), known as the quick SOFA score (qSOFA), replaced the SIRS system of diagnosis.[5] qSOFA criteria for sepsis include at least two of the following three: increased breathing rate, change in the level of consciousness, and low blood pressure.[5] Sepsis guidelines recommend obtaining blood cultures before starting antibiotics; however, the diagnosis does not require the blood to be infected.[3] Medical imaging is helpful when looking for the possible location of the infection.[10] Other potential causes of similar signs and symptoms include anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism.[3]

Sepsis requires immediate treatment with intravenous fluids and antimicrobials.[2][6] Ongoing care often continues in an intensive care unit.[2] If an adequate trial of fluid replacement is not enough to maintain blood pressure, then the use of medications that raise blood pressure becomes necessary.[2] Mechanical ventilation and dialysis may be needed to support the function of the lungs and kidneys, respectively.[2] A central venous catheter and an arterial catheter may be placed for access to the bloodstream and to guide treatment.[10] Other helpful measurements include cardiac output and superior vena cava oxygen saturation.[10] People with sepsis need preventive measures for deep vein thrombosis, stress ulcers, and pressure ulcers unless other conditions prevent such interventions.[10] Some people might benefit from tight control of blood sugar levels with insulin.[10] The use of corticosteroids is controversial, with some reviews finding benefit,[11][12] and others not.[13]

Disease severity partly determines the outcome.[7] The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and septic shock 80%.[7] Sepsis affected about 49 million people in 2017, with 11 million deaths (1 in 5 deaths worldwide).[14] In the developed world, approximately 0.2 to 3 people per 1000 are affected by sepsis yearly, resulting in about a million cases per year in the United States.[7][8] Rates of disease have been increasing.[10] Sepsis is more common among males than females.[3] Descriptions of sepsis date back to the time of Hippocrates.[15] The terms "septicemia" and "blood poisoning" have been used in various ways and are no longer recommended.[15][16]

References[edit]

  1. ^ "Blood Culture Collection" (PDF). WVUH Laboratories. 7 April 2012. Archived (PDF) from the original on 23 March 2020. Retrieved 23 March 2020.
  2. ^ a b c d e f g h i "Sepsis Questions and Answers". cdc.gov. Centers for Disease Control and Prevention (CDC). 22 May 2014. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
  3. ^ a b c d e f g h i j k Jui, Jonathan; et al. (American College of Emergency Physicians) (2011). "Ch. 146: Septic Shock". In Tintinalli, Judith E.; et al. (eds.). Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7th ed.). New York: McGraw-Hill. pp. 1003–14. ISBN 9780071484800.
  4. ^ a b Deutschman, CS; Tracey, KJ (April 2014). "Sepsis: Current dogma and new perspectives". Immunity. 40 (4): 463–75. doi:10.1016/j.immuni.2014.04.001. PMID 24745331.
  5. ^ a b c d e Singer M, Deutschman CS, et al. (February 2016). "The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)". JAMA. 315 (8): 801–10. doi:10.1001/jama.2016.0287. PMC 4968574. PMID 26903338.
  6. ^ a b Rhodes A, Evans LE, et al. (March 2017). "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016". Intensive Care Medicine. 43 (3): 304–377. doi:10.1007/s00134-017-4683-6. PMID 28101605.
  7. ^ a b c d e Jawad I, Lukšić I, et al. (June 2012). "Assessing available information on the burden of sepsis: Global estimates of incidence, prevalence and mortality". Journal of Global Health. 2 (1): 010404. doi:10.7189/jogh.01.010404. PMC 3484761. PMID 23198133.
  8. ^ a b Martin GS (June 2012). "Sepsis, severe sepsis and septic shock: Changes in incidence, pathogens and outcomes". Expert Review of Anti-infective Therapy. 10 (6): 701–6. doi:10.1586/eri.12.50. PMC 3488423. PMID 22734959.
  9. ^ Chao C, Muming Y, Yanfen C (2019). "Pathological Alteration and Therapeutic Implications of Sepsis-Induced Immune Cell Apoptosis". Cell Death & Disease. 10 (10): 782. doi:10.1038/s41419-019-2015-1. PMC 6791888. PMID 31611560.
  10. ^ a b c d e f g h i Dellinger RP, Levy MM, et al. (February 2013). "Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012". Critical Care Medicine. 41 (2): 580–637. doi:10.1097/CCM.0b013e31827e83af. PMID 23353941.
  11. ^ Annane, D; Bellissant, E; Bollaert, PE; Briegel, J; Keh, D; Kupfer, Y; Pirracchio, R; Rochwerg, B (6 December 2019). "Corticosteroids for treating sepsis in children and adults". The Cochrane Database of Systematic Reviews. 12: CD002243. doi:10.1002/14651858.CD002243.pub4. PMC 6953403. PMID 31808551.
  12. ^ Fang F, Zhang Y, et al. (February 2019). "Association of corticosteroid treatment with outcomes in adult patients with sepsis: A systematic review and meta-analysis". JAMA Internal Medicine. 179 (2): 213–223. doi:10.1001/jamainternmed.2018.5849. PMC 6439648. PMID 30575845.
  13. ^ Long B, Koyfman A (November 2017). "Controversies in corticosteroid use for sepsis". The Journal of Emergency Medicine. 53 (5): 653–661. doi:10.1016/j.jemermed.2017.05.024. PMID 28916121.
  14. ^ Rudd, Kristina E; Johnson, Sarah Charlotte; Agesa, Kareha M; Shackelford, Katya Anne; Tsoi, Derrick; Kievlan, Daniel Rhodes; Colombara, Danny V; Ikuta, Kevin S; Kissoon, Niranjan; Finfer, Simon; Fleischmann-Struzek, Carolin; Machado, Flavia R; Reinhart, Konrad K; Rowan, Kathryn; Seymour, Christopher W; Watson, R Scott; West, T Eoin; Marinho, Fatima; Hay, Simon I; Lozano, Rafael; Lopez, Alan D; Angus, Derek C; Murray, Christopher J L; Naghavi, Mohsen (January 2020). "Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study". The Lancet. 395 (10219): 200–211. doi:10.1016/S0140-6736(19)32989-7. PMC 6970225. PMID 31954465.
  15. ^ a b Angus DC, van der Poll T (August 2013). "Severe sepsis and septic shock". The New England Journal of Medicine. 369 (9): 840–51. doi:10.1056/NEJMra1208623. PMID 23984731. {{cite journal}}: Unknown parameter |laydate= ignored (help); Unknown parameter |layurl= ignored (help)
  16. ^ Bone RC, Balk RA, et al. (The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine) (June 1992). "Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis". Chest. 101 (6): 1644–55. doi:10.1378/chest.101.6.1644. PMID 1303622. Archived from the original on 5 May 2019. Retrieved 19 February 2019. Septicemia... has been used... in a variety of ways... We therefore suggest that this term be eliminated from current usage.
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