Causes And Consequences Of Sepsis

Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a

Discuss the cascade of host inflammatory responses that produce the major detrimental effects seen in sepsis due to gram-negative bacteria.

Sepsis is the number one cause of death in intensive care units in the U.S. More than 750,000 cases of sepsis occur each year and about one third of those patients die from it (McKinney, 2014; Ulloa, 2011). Sepsis is a serious condition that is a result of an inflammatory response to infection that can damage organs if left untreated. Severe sepsis occurs when the infection leads to organ dysfunction. Septic shock is when multiple organ failure occurs due to infection and is worse than sepsis and severe sepsis.

Sepsis is defined by the Surviving Sepsis Campaign (SSC) as “the presence (probable or documented) of infection together with systemic manifestations of infection” (Dellinger et al.,

There is a disease continuum with increasing severity if not treated or not responsive to treatment o Sepsis

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

According to information published by the Mayo Clinic, sepsis has three stages: sepsis, severe sepsis and septic shock. The mortality rate for septic shock is nearly 50 per cent, and an episode of severe sepsis increases the risk of future infections. Severe sepsis causes blood flow to the vital organs, such as the brain, heart and kidneys, to become impaired. Sepsis can also cause blood clots to form in organs and extremities such as arms, legs, fingers and toes, which can lead to organ failure and tissue death (gangrene).

Septic shock results from bacteria that multiply in the blood and then releases toxins that decrease blood pressure, thus, impairing blood flow to cells, tissues and organs. It is an acute infection, usually systemic, that overwhelms the body (toxic shock syndrome) (Huether & Mccance, 2012). This

Septicemia is an infection from a life threatening complication, such as pneumonia, kidney infections, a gunshot wound or have been severely burned. Septicemia is also known as bacteremia or blood poisoning, if it is left untreated it might progress into sepsis. Some symptoms pertaining to Septicemia are reduced urine volume, rapid respiration, fever and confusion to think clearly.

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

A methodical search was undertaken of the databases – PubMed, CINAHL and ScienceDirect to ascertain the most appropriate evidence. Search terms used were “Sepsis Prevention”, “Sepsis Management” “Sepsis Early Recognition” and “Sepsis Detection” and merged using Boolean Logic (Glasper and Rees,

Not all bacteremias lead to sepsis. People have everyday bacteremia, particularly, from oral cavity, but sepsis develops rarely [27-31]. It occurs when the infection is resistant to host antibacterial defense. The latter is different in the bloodstream and tissues. If the infection develops locally (tissue, cavity, etc.) and then enters the bloodstream, there are two stages of sepsis: pre-septic (local) and septic (generalized). If infection enters the bloodstream directly from an external source (contaminated intravenous injection, bite, etc.), the pre-septic stage is absent. Local antibacterial defense is provided by phagocytosis (leukocytes and their local versions: resident macrophages), complement, NETs, etc., whereas in the bloodstream

Septic shock is a subset of severe sepsis and was defined as “sepsis-induced hypotension persisting despite adequate fluid resusci- tation” (see Fig. 12.1). While the quantity of fluid that qualifies as “adequate fluid resuscitation” is controversial, we believe septic shock is best defined as a “mean arterial pressure (MAP) less than 65 mmHg after a fluid challenge of 20 mL/Kg body weight (given 30–60 minutes) in patients with sepsis and in the absence of other causes for hypotension” (also see Chap. 14). According to the ACCP/SCCM defini- tions, three stages in the hierarchy of the host’s response to infection were recognized, namely, sepsis, severe sepsis and septic shock, with sepsis having the best prognosis and septic shock the worst. While the use of the SIRS criteria to define sepsis is some- what controversial [3–6], many consider sepsis to be best defined as the “systemic response to infection with the presence of some degree of organ dysfunction”

This clinical report will be discussing the potential life threatening effects “from cellulitis to septic shock”. Cellulitis is the starting cause of an infection that will lead through the sepsis cycle, finishing with the severe part septic shock (Swartz, 2004). Analysation of the interrelationships between localised infection, systemic inflammation response syndrome (SIRS), and the sepsis course will be discussed throughout this report. Additionally, this report will incorporate comprehensive detail of the physiological systemic weakening that can prompt septic shock. Finally, in-depth details about the investigation towards the red flags of disintegration, for example, intense respiratory trouble disorder will be analysed.

The review presents different aspects of the pathogenesis of sepsis and septic shock, particularly, the scenarios of sepsis development dependent upon bacterial resistance to killing by oxidation in the bloodstream. The manuscript shows a neglected factor in sepsis pathogenesis: oxidation of plasma components by oxygen released from erythrocytes. It also attracts the attention of readers to: 1) the role of erythrocytes in the clearing of bacteria from the bloodstream in bacteremia and sepsis; 2) the mechanisms of bacterial defense against killing by oxidation in the bloodstream; 3) the consequences of colonization of the inner space of erythrocytes by bacteria and the problems of antibacterial therapy in case of available bacterial reservoir