RAZVOJ DEFINICIJE SEPSE

Nemanja Dimić; Marko  Đurić; Irina Nenadić; Marina Boboš; Suzana Bojić; Tatjana Vukotić; Mirjana Simeunović Gojgić; Milan Gojgić; Predrag Stevanović; Ksenija Bojović

doi:10.5937/smclk4-42608

Nemanja Dimić KBC "Dr Dragiša Mišović"
Marko Đurić University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Irina Nenadić University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Marina Boboš University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia
Suzana Bojić University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Tatjana Vukotić University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia
Mirjana Simeunović Gojgić City Institute for Public Health, Belgrade, Serbia
Milan Gojgić University Hospital Medical Center Bežanijska kosa, Belgrade, Serbia
Predrag Stevanović University Clinical Hospital Center Dr Dragiša Mišović – Dedinje, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Ksenija Bojović University of East Sarajevo, Faculty of Medicine Foča, Republic of Srpska

DOI: https://doi.org/10.5937/smclk4-42608

Keywords: sepsis, definition, mortality

Abstract

Sepsis is a significant health problem, considering that, annually, over 20 million people fall ill from sepsis. Despite the significant development of medicine in recent decades, the mortality rate of sepsis is exceptionally high (about 26%). The definition of sepsis developed together with the understanding of the mechanism of sepsis. At the beginning of the 1990s, the first definition of sepsis was created, according to which sepsis was defined as systemic inflammatory response syndrome (SIRS), with the presence of suspicion or evidence of infection. Due to many inadequately diagnosed patients with sepsis, another definition was created, according to which sepsis is defined as a clinical syndrome. As the result of the lack of clarity of the previous definitions and the new information on the pathophysiological process of sepsis, a third definition of sepsis was developed in 2016. According to this definition, sepsis is a life-threatening condition based on organic dysfunction resulting from the body's inappropriate response to infection. Septic shock manifests as circulatory, cellular and metabolic instability. It is characterized by a serum lactate level higher than 2 mmol/l and hypotension, which requires vasopressor therapy after the administration of intravenous solutions. This definition of sepsis and septic shock enables early recognition and treatment of patients with sepsis, which are critical steps in reducing the incidence and mortality from this disease.

References

1. Rhee C, Dantes R, Epstein L, Murphy DJ, Seymour CW, Iwashyna TJ, et al.; CDC Prevention Epicenter Program. Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014. JAMA. 2017 Oct 3;318(13):1241-1249. doi: 10.1001/jama.2017.13836.

2. Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al.; International Forum of Acute Care Trialists. Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72. doi: 10.1164/rccm.201504-0781OC.

3. Srzić I, Nesek Adam V, Tunjić Pejak D. SEPSIS DEFINITION: WHAT'S NEW IN THE TREATMENT GUIDELINES. Acta Clin Croat. 2022 Jun;61(Suppl 1):67-72. doi: 10.20471/acc.2022.61.s1.11.

4. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013 Aug 29;369(9):840-51. doi: 10.1056/NEJMra1208623.

5. Funk DJ, Parrillo JE, Kumar A. Sepsis and septic shock: a history. Crit Care Clin. 2009 Jan;25(1):83-101, viii. doi: 10.1016/j.ccc.2008.12.003.

6. Thurston AJ. Of blood, inflammation and gunshot wounds: the history of the control of sepsis. Aust N Z J Surg. 2000 Dec;70(12):855-61. doi: 10.1046/j.1440-1622.2000.01983.x.

7. Gül F, Arslantaş MK, Cinel İ, Kumar A. Changing Definitions of Sepsis. Turk J Anaesthesiol Reanim. 2017 Jun;45(3):129-138. doi: 10.5152/TJAR.2017.93753.

8. Kosanović Ćetković D. Sepsa. U Udžbenik akutnih infektivnih bolesti. 1981;1(C):29-33.

9. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al.; Surviving Sepsis Campaign Management Guidelines Committee. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004 Mar;32(3):858-73. doi: 10.1097/01.ccm.0000117317.18092.e4.

10. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992 Jun;20(6):864-74.

11. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644-55. doi: 10.1378/chest.101.6.1644.

12. Salomao R, Brunialti MK, Rapozo MM, Baggio-Zappia GL, Galanos C, Freudenberg M. Bacterial sensing, cell signaling, and modulation of the immune response during sepsis. Shock. 2012 Aug;38(3):227-42. doi: 10.1097/SHK.0b013e318262c4b0.

13. Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al.; International Sepsis Definitions Conference. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 2003 Apr;29(4):530-8. doi: 10.1007/s00134-003-1662-x.

14. Timsit JF, Perner A. Sepsis: find me, manage me, and stop me! Intensive Care Med. 2016 Dec;42(12):1851-1853. doi: 10.1007/s00134-016-4603-1.

15. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al.; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013 Feb;39(2):165-228. doi: 10.1007/s00134-012-2769-8.

16. Bone RC. The pathogenesis of sepsis. Ann Intern Med. 1991 Sep 15;115(6):457-69. doi: 10.7326/0003-4819-115-6-457.

17. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-377. doi: 10.1007/s00134-017-4683-6.

18. DeMerle KM, Royer SC, Mikkelsen ME, Prescott HC. Readmissions for Recurrent Sepsis: New or Relapsed Infection? Crit Care Med. 2017 Oct;45(10):1702-1708. doi: 10.1097/CCM.0000000000002626.

19. Carneiro AH, Póvoa P, Gomes JA. Dear Sepsis-3, we are sorry to say that we don't like you. Rev Bras Ter Intensiva. 2017 Jan-Mar;29(1):4-8. doi: 10.5935/0103-507X.20170002.

20. Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al.; Sepsis Definitions Task Force. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):775-87. doi: 10.1001/jama.2016.0289.

21. Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):762-74. doi: 10.1001/jama.2016.0288.

22. Besen BAMP, Romano TG, Nassar AP Jr, Taniguchi LU, Azevedo LCP, Mendes PV, Zampieri FG, Park M. Sepsis-3 definitions predict ICU mortality in a low-middle-income country. Ann Intensive Care. 2016 Dec;6(1):107. doi: 10.1186/s13613-016-0204-y.

23. Alberto L, Marshall AP, Walker R, Aitken LM. Screening for sepsis in general hospitalized patients: a systematic review. J Hosp Infect. 2017 Aug;96(4):305-315. doi: 10.1016/j.jhin.2017.05.005.

24. Bumbaširević V, Veličković J, Palibrk I, Jovanović B, Avramović J. Novine u dijagnostici i lečenju sepse i septičnog šoka (Novine u lečenju sepse). Serbian Journal of Anesthesia and Intensive Therapy. 2017;39(7-8):171-80.

25. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.

26. Serafim R, Gomes JA, Salluh J, Póvoa P. A Comparison of the Quick-SOFA and Systemic Inflammatory Response Syndrome Criteria for the Diagnosis of Sepsis and Prediction of Mortality: A Systematic Review and Meta-Analysis. Chest. 2018 Mar;153(3):646-655. doi: 10.1016/j.chest.2017.12.015.

27. Freund Y, Lemachatti N, Krastinova E, Van Laer M, Claessens YE, Avondo A, et al.; French Society of Emergency Medicine Collaborators Group. Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department. JAMA. 2017 Jan 17;317(3):301-308. doi: 10.1001/jama.2016.20329.

28. Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, Bellamy SL, Christie JD. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. 2009 May;37(5):1670-7. doi: 10.1097/CCM.0b013e31819fcf68.

29. Lamontagne F, Harrison DA, Rowan KM. qSOFA for Identifying Sepsis Among Patients With Infection. JAMA. 2017 Jan 17;317(3):267-268. doi: 10.1001/jama.2016.19684.

DEVELOPMENT OF THE DEFINITION OF SEPSIS

Abstract

References