Sepsis: From Pathophysiology to Individualized Patient Care

László, István; Trásy, Domonkos; Molnár, Zsolt; Fazakas, János

doi:10.1155/2015/510436

Cited by 71 publications

(65 citation statements)

References 114 publications

(110 reference statements)

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“…The adaptive immune response is based on maturation and proliferation, both influenced by the "cytokine signature" of the innate response. However, in the case of an unbalanced, dysregulated response, the localized process goes out of control and becomes systemic, giving way for impairing the function of distant vital organs [95].…”

Section: The Effect Of Iah and Critical Illness On Gut Permeability Amentioning

confidence: 99%

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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Evaluating the degree of organ dysfunction is a cornerstone in distinguishing patients with critical illness from those without. However, evaluation of the gastrointestinal function in critically ill patients is not unified, and is still largely based on subjective clinical evaluation. Although intra-abdominal pressure has been proposed as a parameter to facilitate monitoring of abdominal compartment in critical illness, the interactions between intra-abdominal pressure and gastrointestinal function are poorly clarified. The aim of this current review is to describe interactions and associations between gastrointestinal dysfunction and intra-abdominal pressure from a pathophysiological and clinical point of view.

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Section: The Effect Of Iah and Critical Illness On Gut Permeability Amentioning

confidence: 99%

Abdominal pressure and gastrointestinal function: an inseparable couple?

Blaser¹,

Malbrain²,

Regli³

2017

Anaesthesiol Intensive Ther

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“…However, none of them has a specificity or sensitivity such that they can be used in clinical practice. 38,39 Doherty et al defined a biomarker as "a characteristic that is objectively measured and evaluated as an indicator of normal biologic process or pathogenic process". 40 Thus, in order to use a biomarker for clinical practice, it must have a high diagnostic accuracy, sensitivity, specificity, and both positive and negative predictive values.…”

Section: Biological Markers Of Sepsismentioning

confidence: 99%

In vitro diagnosis of sepsis: a review

Marcello

Tumolo²,

Donno³

et al. 2016

PLMI

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Sepsis, severe sepsis and septic shock, systemic inflammatory response, and other related manifestations represent a relevant medical problem with high morbidity and mortality, despite the improvements in diagnosis, treatment, and preventive measures over the last few decades. The limited knowledge of the pathophysiology in association with the lack of in vitro diagnostic methods for the certain and quick determination of the causative microbiological agents and their antibiotic resistance means the condition is still critical and of high impact in health care. The current gold standard method to detect the sepsis-causing pathogens, which is based on blood culture, is still insufficiently sensitive and slow. The new culture-independent molecular biology-based techniques can lead to the identification of a broad range of microorganisms and resistance markers within a few hours and with high sensitivity and specificity; nevertheless, limitations of, for example, the polymerase chain reaction-based methods still hamper their application in the clinical routine. This review summarizes the in vitro diagnostic methods and their approach in the clinical diagnosis of the bloodstream infections, and explores their advantages and disadvantages at the current state of the art. A quick analysis of the future prospective in multiplex technologies for microbiological diagnosis of sepsis is also provided.

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“…Initially, local activation of the innate immune response by pathogen-associated and damageassociated molecular patterns results in a cytokine storm (Wang and Ma, 2008;Gustot, 2011;László et al, 2015). If the inflammatory response becomes systemic it manifests as the systemic inflammatory response syndrome (SIRS) (Conference, 1992).…”

Section: Introductionmentioning

confidence: 99%

Could Biomarkers Direct Therapy for the Septic Patient?

Sims

Nguyen

Mayeux

2016

Journal of Pharmacology and Experimental Therapeutics

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Sepsis is a serious medical condition caused by a severe systemic inflammatory response to a bacterial, fungal, or viral infection that most commonly affects neonates and the elderly. Advances in understanding the pathophysiology of sepsis have resulted in guidelines for care that have helped reduce the risk of dying from sepsis for both children and older adults. Still, over the past three decades, a large number of clinical trials have been undertaken to evaluate pharmacological agents for sepsis. Unfortunately, all of these trials have failed, with the use of some agents even shown to be harmful. One key issue in these trials was the heterogeneity of the patient population that participated. What has emerged is the need to target therapeutic interventions to the specific patient's underlying pathophysiological processes, rather than looking for a universal therapy that would be effective in a "typical" septic patient, who does not exist. This review supports the concept that identification of the right biomarkers that can direct therapy and provide timely feedback on its effectiveness will enable critical care physicians to decrease mortality of patients with sepsis and improve the quality of life of survivors.

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Sepsis: From Pathophysiology to Individualized Patient Care

Cited by 71 publications

References 114 publications

Abdominal pressure and gastrointestinal function: an inseparable couple?

Abdominal pressure and gastrointestinal function: an inseparable couple?

In vitro diagnosis of sepsis: a review

Could Biomarkers Direct Therapy for the Septic Patient?

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