Sepsis and septic shock:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Critical care clinics
16,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | VIII S., S. 179 - 371 Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Sepsis and septic shock |c Robert A. Balk ... guest eds. |
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Datensatz im Suchindex
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| adam_text | SEPSIS AND SEPTIC SHOCK
CONTENTS
Preface ix
Robert A. Balk and Larry C. Casey
Severe Sepsis and Septic Shock: Definitions,
Epidemiology, and Clinical Manifestations 179
Robert A. Balk
Sepsis and septic shock are frequently encountered disorders in
the critical care environment and are associated with increased
morbidity and mortality. Despite an improved understanding of
the pathogenesis and technological improvements in the support
of the critically ill over the past couple of decades, the associated
mortality rate from severe sepsis and septic shock is still relatively
high. This article reviews the current definitions and common
clinical manifestation of severe sepsis and septic shock.
Immunologic Response to Infection and its Role in
Septic Shock 193
Larry C. Casey
This article explores the events that take place when bacteria
penetrate our skin or mucosal surfaces triggering a vigorous host
response including complement activation, antibody formation
(initially thymus independent and eventually thymus depen
dent), phagocytosis, production of antibacterial peptides and pro¬
teins, oxygen free radicals, the production of cytokines, and acti¬
vation of the coagulation system. If the mediators of the vigorous
host response spill into the systemic circulation, there is resulting
multisystem organ failure and potential mortality.
CRITICAL CARE CLINICS
VOLUME 16 • NUMBER 2 • APRIL 2000 V
Antibiotic Selection for Patients with Septic Shock 215
David Simon and Gordon Trenholme
This article provides general guidelines for selecting empiric anti¬
biotic therapy for patients with overwhelming sepsis. Potential
pathogens as they relate to suspected sites of infection are high¬
lighted.
Pharmacologic Issues in the Management of
Septic Shock 233
Nidhi Jindal, Steven M. Hollenberg,
and R. Phillip Dellinger
Initial stabilization of a patient in septic shock requires attention
to the basics of airway, breathing, and circulation (the ABCs).
Volume resuscitation, vasopressor therapy, and inotropic therapy
represent key components of subsequent patient care. Issues re¬
lated to splanchnic circulation, renal dysfunction, and oxygen
delivery in the context of septic shock are addressed. In addition,
bicarbonate, steroid, and experimental therapies in the manage¬
ment of septic shock are reviewed.
Myocardial Dysfunction in Septic Shock 251
Anand Kumar, Cameron Haery, and Joseph E. Parrillo
Septic shock is almost uniformly associated with an increased
cardiac output and decreased systemic vascular resistance when
patients are adequately volume resuscitated. Despite the in¬
creased cardiac output, septic myocardial depression is common.
Most patients experience biventricular dilatation, a decrease in
ejection fraction, and a depressed Frank Starling response. In
addition, diastolic compliance abnormalities may be seen. These
responses may be adaptive and can herald a good outcome.
The mechanism underlying septic myocardial depression is not
myocardial hypoperfusion but rather the direct cellular effects of
circulating or local mediators, particularly the cytokines TNF a
and IL ip. These cytokines may depress baseline and catechola
mine stimulated myocardial contractility by a variety of mecha¬
nisms. Nitric oxide generation is one such mechanism.
Acute Lung Injury and Acute Respiratory Distress
Syndrome in Sepsis and Septic Shock 289
Alan M. Fein and Mylene G. Calalang Colucci
The relationship between sepsis and the acute respiratory distress
syndrome (ARDS) has been recognized for decades. Intense re¬
search since the syndrome was first described by Ashbaugh and
vi CONTENTS
his co workers more than 30 years ago, has provided a better
understanding of the definition, pathogenesis, and management
of this syndrome. This article further elucidates the relationship
between ARDS and sepsis. Different supportive modalities of
mechanical ventilation and pharmacologic adjuncts for the man¬
agement of sepsis induced ARDS are also discussed.
Metabolic Derangements in Sepsis and Septic Shock 319
Barry A. Mizock
This article examines the spectrum of metabolic alterations in
sepsis and septic shock. The clinical manifestations, neuroendo
crine control, and bioenergetics of the ebb and flow phases
of sepsis are reviewed. Characteristic alterations in carbohydrate,
fat, and protein metabolism induced by sepsis are outlined. Fi¬
nally, the implications of these metabolic alterations for the nutri¬
tional support of patients with sepsis are discussed.
Pathogenesis and Management of Multiple Organ
Dysfunction or Failure in Severe Sepsis and
Septic Shock 337
Robert A. Balk
Organ system dysfunction is a common adverse sequelae of se¬
vere sepsis and septic shock and has been reported to be the most
common cause of death in the noncoronary intensive care unit.
The pathophysiology of the development of multiple organ sys¬
tem dysfunction is likely multifactoral and may take several dif¬
ferent pathways. The frequency of specific organ system involve¬
ment is dependent on the definition used to describe the organ
dysfunction. The presence of organ dysfunction has great clinical
impact on the underlying disease process, can prolong the hospi¬
tal stay, increase the cost of care, and has been associated with an
increase in mortality rate. At present, there is no recognized
specific treatment for established organ failure, this primary atten¬
tion has been directed toward prevention.
Scoring Systems for Assessing Organ Dysfunction
and Survival 353
Jean Louis Vincent, Flavio Ferreira, and Rui Moreno
Sepsis is associated with high mortality and morbidity. Scoring
systems to describe organ dysfunction or predict survival are
widely used in septic, as in other critically ill, patients. Such
scores can facilitate description of patient populations, for exam¬
ple, for inclusion in clinical trials, and can enable comparison
between intensive care units or within the same intensive care
CONTENTS vii
unit over time. Although early systems focused primarily on
survival prediction or the presence or absence of organ failure,
recent years have seen the development of newer models able to
describe the evolution of individual and multiple organ dysfunc¬
tion. The authors discuss the organ dysfunction and survival
scoring systems most commonly used in the intensive care unit.
Index 367
Subscritpion Information Inside back cover
viii CONTENTS
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| illustrated | Illustrated |
| indexdate | 2024-07-09T18:39:23Z |
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| language | English |
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| physical | VIII S., S. 179 - 371 Ill., graph. Darst. |
| publishDate | 2000 |
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| publisher | Saunders |
| record_format | marc |
| series | Critical care clinics |
| series2 | Critical care clinics |
| spelling | Sepsis and septic shock Robert A. Balk ... guest eds. Philadelphia [u.a.] Saunders 2000 VIII S., S. 179 - 371 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care clinics 16,2 Choc septique Défaillance multiviscérale Sepsie Septikemie gtt Multiple Organ Failure Sepsis Shock, Septic Septischer Schock (DE-588)4193151-8 gnd rswk-swf Sepsis (DE-588)4181014-4 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Sepsis (DE-588)4181014-4 s Septischer Schock (DE-588)4193151-8 s DE-604 Balk, Robert A. Sonstige oth Critical care clinics 16,2 (DE-604)BV000019838 16,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008937844&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Sepsis and septic shock Critical care clinics Choc septique Défaillance multiviscérale Sepsie Septikemie gtt Multiple Organ Failure Sepsis Shock, Septic Septischer Schock (DE-588)4193151-8 gnd Sepsis (DE-588)4181014-4 gnd |
| subject_GND | (DE-588)4193151-8 (DE-588)4181014-4 (DE-588)4143413-4 |
| title | Sepsis and septic shock |
| title_auth | Sepsis and septic shock |
| title_exact_search | Sepsis and septic shock |
| title_full | Sepsis and septic shock Robert A. Balk ... guest eds. |
| title_fullStr | Sepsis and septic shock Robert A. Balk ... guest eds. |
| title_full_unstemmed | Sepsis and septic shock Robert A. Balk ... guest eds. |
| title_short | Sepsis and septic shock |
| title_sort | sepsis and septic shock |
| topic | Choc septique Défaillance multiviscérale Sepsie Septikemie gtt Multiple Organ Failure Sepsis Shock, Septic Septischer Schock (DE-588)4193151-8 gnd Sepsis (DE-588)4181014-4 gnd |
| topic_facet | Choc septique Défaillance multiviscérale Sepsie Septikemie Multiple Organ Failure Sepsis Shock, Septic Septischer Schock Aufsatzsammlung |
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