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Review
. 2017 Feb;49(1):53-58.
doi: 10.5152/eurasianjmed.2017.17062.

Sepsis and Septic Shock: Current Treatment Strategies and New Approaches

Gizem Polat  1 , Rustem Anil Ugan  2 , Elif Cadirci  2 , Zekai Halici  2
Affiliations
Review

Sepsis and Septic Shock: Current Treatment Strategies and New Approaches

Gizem Polat et al. Eurasian J Med. 2017 Feb.

Abstract
in English, Turkish

Sepsis is a complex condition characterized by the simultaneous activation of inflammation and coagulation in response to microbial insult. These events manifest as systemic inflammatory response syndrome or sepsis symptoms through the release of proinflammatory cytokines, procoagulants, and adhesion molecules from immune cells and/or damaged endothelium. Today, sepsis is a severe multisystem disease with difficult treatments for its manifestations and high mortality rates. In the last two decades in particular, many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes. In sepsis, increasing antibiotic resistance and medicine-resistant hemodynamic changes have resulted in further research on new treatment modalities in addition to classical treatments. In the last decade, the sepsis physiopathology has been elucidated. Various therapeutic agents have been used in addition to antibiotherapy, but no satisfactory results have been obtained. This review summarizes the sepsis pathophysiology, current treatment protocols, and new approaches.

Sepsis, mikrobiyal maruziyet sonrasında enflamasyon ve koagülasyonun birlikte aktive olmasıyla karakterize komleks bir sendromdur. Bu olaylar, immün hücreler veya hasar görmüş endotel hücrelerinden salınan proinflamatuvar sitokinler, prokoagülanlar ve adezyon molekülleri yoluyla sistemik enflamatuvar yanıt sendromu veya sepsis bulguları ile ortaya çıkar. Sepsis, günümüzde halen yüksek mortalite ile seyreden tedavisi güç bir klinik tablodur. Birçok sistemi tutan, özellikle hemodinamik değişikliklere yol açarak şok, organ fonksiyon bozukluğu ve organ yetmezliğine giden sepsis hakkında özellikle son yirmi yılda pek çok çalışma yapılmıştır. Sepsiste özellikle artan antibiyotik direnci ve septik şok fazındaki tedaviye dirençli hemodinamik değişiklikler, klasik tedavilere ek olarak yeni tedavi teknikleri geliştirme çabalarına neden olmuştur. Fizyopatolojisi daha iyi anlaşıldıkça, antibiyotik tedavisine ilave olarak birçok ajan denenmiş ama hala yeterli sonuçlar elde edilememiştir. Bu derlemede sepsis patofizyolojisi, mevcut tedavileri ve yeni yaklaşımları özetlenmiştir.

Keywords: Critical care; sepsis; septic shock.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

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