Advances in the understanding of clinical manifestations and therapy of severe sepsis: an update for critical care nurses.

Severe sepsis is a major public health concern and a burden on the healthcare system. Despite improvements in efforts to control the source of infection and increased recognition by healthcare providers of patients with the disease, the mortality rate remains unacceptably high, from 30% to 50%. The...

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Publicado en:American Journal of Critical Care Vol. 12; no. 2; pp. 120 - 136
Autores principales: Ely EW, Kleinpell RM, Goyette RE
Formato: CEU exam questions glossary tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Mar2003
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2003
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        atl: Advances in the understanding of clinical manifestations and therapy of severe sepsis: an update for critical care nurses.
      aug:
        au:
          Ely EW
          Kleinpell RM
          Goyette RE
        affil: Department of Medicine, Division of Allergy, Pulmonary, and Critical Care Medicine, Tennessee Valley Veterans Affairs Geriatric Research Education and Clinical Center, Vanderbilt University School of Medicine, Nashville, TN
      sug:
        subj:
          Fibrinolytic Agents
          Multiple Organ Dysfunction Syndrome Drug Therapy
          Sepsis Drug Therapy
          Sepsis Symptoms
          Blood Coagulation Disorders
          C-Reactive Protein
          Clinical Trials
          Critical Care Nursing
          Education, Continuing (Credit)
          Fibrinolytic Agents Pharmacodynamics
          Multiple Organ Dysfunction Syndrome Physiopathology
          Multiple Organ Dysfunction Syndrome Symptoms
          Nursing Assessment
          Patient Selection
          Sepsis
          Sepsis Complications
          Sepsis Mortality
          Sepsis Prevention and Control
          Sepsis Prognosis
          Systemic Inflammatory Response Syndrome
      ab: Severe sepsis is a major public health concern and a burden on the healthcare system. Despite improvements in efforts to control the source of infection and increased recognition by healthcare providers of patients with the disease, the mortality rate remains unacceptably high, from 30% to 50%. The systemic inflammatory response syndrome criteria are used as diagnostic indicators of sepsis when they occur in patients with known or suspected infection. The outcome of a patient with severe sepsis is often related to the occurrence of sepsis-induced multiple organ dysfunction syndrome. Multiple organ dysfunction syndrome appears to result from a cascade of organism-related factors, inflammatory mediators, endothelial injury, disturbed hemostasis, and microcirculatory abnormalities. In patients with severe sepsis, derangements of inflammation and coagulation are tightly linked. Although numerous clinical trials focused on interventions in one or the other of the inflammatory and coagulation systems failed to show reduced mortality due to sepsis, a member of a new class of drugs called 'cogins' was effective. In its active form, protein C has anti-inflammatory, antithrombotic, and profibrinolytic properties that can reduce organ injury associated with severe sepsis. A recombinant form of activated protein C, drotrecogin alfa (activated), significantly reduces 28-day mortality due to all causes in patients with severe sepsis and has an acceptable safety profile. This review provides an overview of severe sepsis, highlighting recent advances in treatment of the disease and the role of critical care nurses.
      pubtype: Academic Journal
      doctype:
        CEU
        exam questions
        glossary
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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