IMR Press / FBE / Volume 2 / Issue 3 / DOI: 10.2741/E150

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Spectrum of sepsis, mediators, source control and management of bundles
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1 Department and School of Anesthesia and Intensive Care, Catania University-Hospital, Via S. Sofia, 78 95125 Catania, Italy
2 Department of Biological Chemistry, Medical Chemistry and Molecular Biology, University of Catania, Via Andrea Doria, 6 95125 Catania, Italy
3 Department of Surgery and Transplantation Catholic University, Via Regina Elena 8, Roma, Italy
4 Weil Institute of Critical Care Medicine, 35100 Bob Hope DR, Rancho Mirage, California 92270, USA
Academic Editor:Indrajit Chowdhury
Front. Biosci. (Elite Ed) 2010, 2(3), 906–911; https://doi.org/10.2741/E150
Published: 1 June 2010
(This article belongs to the Special Issue Recent progress in reproductive biology)
Abstract

Sepsis is a modern medicine icon and the onset of organ dysfunction is one of the worst scenario. More than 100 distinct molecules have been proposed as useful biological markers of sepsis. TNF-alpha, IL-6, chemokines and cytokines are considered the first line factors able to drive the dynamic process of sepsis. The PIRO scheme is a new classification of different aspects, used to stage sepsis. Resuscitation bundles must be started within 6 hours of presentation (serum lactate measured; blood cultures obtained before antibiotic therapy; broad-spectrum antibiotics within 3 hours from emergency admission and 1 hour from ICU admission; in case of hypotension and/or lactate higher than 4 mmol/L deliver an initial 20 ml/kg of crystalloid or colloid solution or apply vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure above 65 mmHg). A management bundle should be implemented within 24 hour (low-dose steroids administered for septic shock; recombinant human activated protein C; glucose control maintained at less than 8.3 mmol/L; inspiratory plateau pressures maintained at less than 30 cm H2O).

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