Michael R Pinsky1. 1. Department of Critical Care Medicine, Bioengineering and Anesthesiology, University of Pittsburgh, Pittsburgh, PA 15261, USA. pinskymr@upmc.edu
Abstract
BACKGROUND/AIMS: Sepsis and multiple organ failure are complex processes that result from dysregulation of the immune response and its associated hematological, hemodynamic and metabolic disturbances. METHODS: Review of the pathophysiological basis for sepsis and a review of the literature on its mechanisms of expression. RESULTS: Sepsis is the host response to an injury, often infectious in origin, that creates both pro- and anti-inflammatory immune responses. The level and duration of this response roughly correlates with outcome. Subcellular injury characterized by increased oxidative stress defines the central mitochondrial component of this process. Treatments which minimize the amplification of this response are usually more effective at reducing tissue injury than are measures aimed at suppressing the inflammatory response. CONCLUSIONS: Sepsis is a complex process whose expression and treatment are just now being defined. Treatments that minimize the overall host response still represent the most effective strategies.
BACKGROUND/AIMS: Sepsis and multiple organ failure are complex processes that result from dysregulation of the immune response and its associated hematological, hemodynamic and metabolic disturbances. METHODS: Review of the pathophysiological basis for sepsis and a review of the literature on its mechanisms of expression. RESULTS:Sepsis is the host response to an injury, often infectious in origin, that creates both pro- and anti-inflammatory immune responses. The level and duration of this response roughly correlates with outcome. Subcellular injury characterized by increased oxidative stress defines the central mitochondrial component of this process. Treatments which minimize the amplification of this response are usually more effective at reducing tissue injury than are measures aimed at suppressing the inflammatory response. CONCLUSIONS:Sepsis is a complex process whose expression and treatment are just now being defined. Treatments that minimize the overall host response still represent the most effective strategies.
Authors: Rami Namas; Ruben Zamora; Rajaie Namas; Gary An; John Doyle; Thomas E Dick; Frank J Jacono; Ioannis P Androulakis; Gary F Nieman; Steve Chang; Timothy R Billiar; John A Kellum; Derek C Angus; Yoram Vodovotz Journal: J Crit Care Date: 2011-07-27 Impact factor: 3.425