Development of views on pathophysiology of sepsis


Authors: Jiří Beneš
Authors‘ workplace: Klinika infekčních nemocí 3. LF UK a Nemocnice Na Bulovce, Praha
Published in: Vnitř Lék 2017; 63(7-8): 481-487
Category: Reviews

Overview

Sepsis was understood as a disease caused by an invasive bacterial infection associated with deluging of organism with bacterial toxins (blood poisoning). Schottmüller’s definition emphasized the existence of a focus as the source of invading bacteria. Further research led to the discovery of the cytokine cascade and to the recognition that sepsis is induced by our own endogenous mediators. The dysfunction or failure of various organs in sepsis can be explained both by hemodynamic disorders which originate in the altered microcapillars but also by a complex transformation of metabolism. To explain metabolic changes, the theory of tissue hibernation was postulated. According to the alternative theory, metabolic changes arise due to attenuation of mitochondrial function, which develops as part of a complex antibacterial response. Definitions of sepsis from the mid-19th century to the present are described.

Key words:
pathogenesis of sepsis – sepsis – sepsis definition – septic shock


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Diabetology Endocrinology Internal medicine
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