Sepsis and septic shock

摘要: For more than two decades, sepsis was defined as a microbial infection that produces fever (or hypothermia), tachycardia, tachypnoea and blood leukocyte changes. Sepsis is now increasingly being considered dysregulated systemic inflammatory immune response to invasion organ injury for which mortality rates are declining 15-25%. Septic shock remains with hyperlactataemia concurrent hypotension requiring vasopressor therapy, in-hospital approaching 30-50%. With earlier recognition compliance best practices, has become less of an immediate life-threatening disorder long-term chronic critical illness, often associated prolonged inflammation, suppression, lean tissue wasting. Furthermore, patients who survive have continuing risk after discharge, well cognitive functional deficits. Earlier improved implementation practices reduced mortality, but results from the use immunomodulatory agents date been disappointing. Similarly, no biomarker can definitely diagnose or predict its clinical outcome. Because complexity, improvements in outcomes likely continue be slow incremental.