• Best Pract Res Clin Anaesthesiol · Sep 2004

    Review

    The systemic inflammatory response syndrome.

    • Markus A Weigand, Christian Hörner, Hubert J Bardenheuer, and Axel Bouchon.
    • Department of Anesthesia, University of Heidelberg, Im Neuenheimer Feld 110, Heidelberg 69120, Germany. markus_weigand@med.uni-heidelberg.de
    • Best Pract Res Clin Anaesthesiol. 2004 Sep 1; 18 (3): 455-75.

    AbstractSepsis and septic shock are the leading causes of death in intensive care units in developed countries despite recent advances in critical care medicine. Sepsis is the systemic inflammatory response to infection frequently associated with hypoperfusion followed by tissue injury and organ failure. The activation of monocytes/macrophages and neutrophils, with the consecutive release of pro-inflammatory mediators and activation of the coagulation cascade, seems to play a key role in the pathogenesis of sepsis. Elimination of the septic focus, anti-microbial therapy and supportive treatment are the cornerstones of sepsis therapy. In addition, the application of small doses hydrocortisone to patients with refractory septic shock and the treatment of patients with septic multiple organ failure with activated protein C are two adjunctive therapeutic strategies. Promising new experimental treatment options are interference with MIF, HMGB1, C5a or TREM-1 signal transduction pathways and an inhibition of apoptosis, which may further improve the prognosis of septic patients in the future.

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