Sepsis And Multiple Organ Dysfunction

This is the definitive, gold-standard text on sepsis and multiple-organ dysfunction. It is comprehensive and thoroughly referenced: the one text in which all current knowledge on this important topic is brought together. The book is written by a team of international contributors, overseen by an internationally acclaimed editorial team.

Sepsis is a syndrome or sometimes it is a clinical condition evoked by uncontrolled endotoxin-reactions. These pathophysiological alterations can disturb the organism's homeostasis leading ultimately to a condition of severe organ dysfunction which in itself means a bad prognosis for patient survival. In the last decades researchers and clinicians have been involved in process directed to a better understanding of the basic mechanisms of sepsis and MODS. The best goal will be the achievement of preventive measures and optimization of management in patients suffering severe infections and critical conditions. This objective represents a true challenge at the dawn of the XXI century.

An experienced physician knows how to recognize a patient suffering from sepsis, but cannot accurately determine whether the patient will survive. Cardinal elements of the treatment for sepsis include specific antibiotic and vasoactive drugs, enteral and parenteral nutrition, artificial respiration, and optimization of the oxygen transport to tissues. Nonetheless, with a certain frequency, these techniques are insufficient to ensure the recovery of a critically ill patient, especially when it is necessary to overcome functional alterations subsequent to organ and vital-system overload. The key elements in the progression of the sepsis-MODS syndrome are tied to numerous factors. These include: the severity and location of the lesion; the patient's age; the remaining functional reserve; the presence of mediatory which may be stimulatory, inhibitory or both.

There have been tremendous advances in understanding the cellular mechanisms involved in sepsis and contributing to the development of multiple organ dysfunction and mortality in this setting. The chapters in this book provide up-to-date insights into important pathways that are initiated by sepsis.

Sepsis represents a life threatening condition to ICU patients. The evolution of sepsis to severe sepsis or septic shock may occur in an unpredictable way. In the coming millennium the prevention and management of sepsis and organ dysfunction will present a real challenge for researchers and clinicians.

Sepsis evolution and organ dysfunction are still an enigmatic topic. Severe infection causes an important aggression of the whole body, and the so-called inflammation mediators play an important role in this evolution. It is however certain that the immune system is a key factor in sepsis progression. The volume focuses on some primary aspects such as the research of the rationale of the immune system activation during sepsis, on the molecular strategies available for ARDS treatment and on techniques of emofiltration and absorption of endotoxins through apheresis in the septic patient.