Diagnostic methods in sepsis: the need of speed

被引:28
作者
Coelho, Fernando Rodrigues [2 ]
Martins, Joilson Oliveira [1 ]
机构
[1] Univ Sao Paulo, Fac Pharmaceut Sci, Dept Clin & Toxicol Anal, Lab Immunoendocrinol, BR-05508900 Sao Paulo, Brazil
[2] Univ Sao Paulo, Inst Quim, BR-05508900 Sao Paulo, Brazil
来源
REVISTA DA ASSOCIACAO MEDICA BRASILEIRA | 2012年 / 58卷 / 04期
基金
巴西圣保罗研究基金会;
关键词
Sepsis; methods; cytokines; CRITICALLY-ILL PATIENTS; EARLY LACTATE CLEARANCE; KAPPA-B ACTIVATION; C-REACTIVE PROTEIN; DIABETIC-RATS ROLE; SEPTIC SHOCK; NATRIURETIC PEPTIDE; SIGNALING PATHWAYS; ORGAN FAILURE; INFLAMMATORY RESPONSE;
D O I
10.1590/S0104-42302012000400024
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Sepsis is a common condition encountered in hospital environments. There is no effective treatment for sepsis, and it remains an important cause of death at intensive care units. This study aimed to discuss some methods that are available in clinics, and tests that have been recently developed for the diagnosis of sepsis. Methods: A systematic review was performed through the analysis of the following descriptors: sepsis, diagnostic methods, biological markers, and cytokines. Results: The deleterious effects of sepsis are caused by an imbalance between the invasiveness of the pathogen and the ability of the host to mount an effective immune response. Consequently, the host's immune surveillance fails to eliminate the pathogen, allowing it to spread. Moreover, there is a pro-inflammatory mediator release, inappropriate activation of the coagulation and complement cascades, leading to dysfunction of multiple organs and systems. The difficulty achieve total recovery of the patient is explainable. There is an increased incidence of sepsis worldwide due to factors such as aging population, larger number of surgeries, and number of microorganisms resistant to existing antibiotics. Conclusion: The search for new diagnostic markers associated with increased risk of sepsis development and molecules that can be correlated to certain steps of sepsis is becoming necessary. This would allow for earlier diagnosis, facilitate patient prognosis characterization, and prediction of possible evolution of each case. All other markers are regrettably constrained to research units.
引用
收藏
页码:498 / 504
页数:7
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