SIRS/Sepsis/Septic Shock
“Sepsis: more than 26 million people affected, 9 million deaths every year, 60% mortality when it degenerates into septic shock. The uncontrolled inflammatory response can be remodulated by extracorporeal adsorption of inflammatory mediators”.
Sepsis is defined as an organ dysfunction caused by a dysregulated response of the body.
Understanding the general context of the mechanisms that drive sepsis, remains an open challenge: several theories have been proposed regarding its action.
Pathogen-Associated Molecular patterns (PAMPs) and Damaged-Associated Molecular patterns (DAMPs) have been identified as triggers of the activation of pro- and anti-inflammatory responses.
The invasion of the organism by an external microorganism, determines the release of pro- and anti-inflammatory mediators, ending in the so-called ‘cytokine cascade’. When release is excessive, uncontrolled and beyond the infectious focus, the state of sepsis develops. It is a time-dependent syndrome, in which the clinical outcome is strongly connected to a rapid diagnosis and effective clinical management of the patient.
Septic shock is an evolution of sepsis, in which important circulatory, metabolic and cellular alterations occur, presenting a substantial increase of mortality.
Sepsis is the principal cause of death in intensive care. The degeneration of sepsis into septic shock causes a further increase in mortality, which, depending on the severity of the patient’s condition, can reach percentages higher than 80%, despite the finest medical therapy.
The complexity of these clinical settings, requires the implementation of early multidisciplinary interventions, dedicated to the treatment of a pathology, in which the intervention time is decisive. Therefore, the early diagnosis of sepsis and the activation of the correct timing of therapy/treatment play a fundamental role in determining the septic state of the affected subject.
In septic shock, there is a critical reduction of tissue perfusion which, can lead to a state of multiorgan failure (MOF). In hyperperfused areas, during shock, events of the inflammatory and coagulation cascade are triggered. Patients with septic shock can be identified by the association of the clinical chart determined by sepsis and associated with persistent hypotension with the need for vasopressor drugs.
Multiple extracorporeal therapies have been studied as auxiliary therapy in sepsis, aimed to moderate the cytokine cascade from the blood, with the purpose of promoting relief from septic shock, improving the general clinical chart of the patient.
Molecules to remove: Pro – and anti-inflammatory cytokines, chemokines
Indicated Therapies: CytoSorb®
Diagnostic Tools: abioSCOPE®