A.E. Baue - Böcker

Sepsis represents a life threatening condition to ICU patients. The evolution of sepsis to severe sepsis or septic shock may occur in an unpredictable way. In the coming millennium the prevention and management of sepsis and organ dysfunction will present a real challenge for researchers and clinicians.

An experienced physician knows how to recognize a patient suffering from sepsis, but cannot accurately determine whether the patient will survive. Cardinal elements of the treatment for sepsis include specific antibiotic and vasoactive drugs, enteral and parenteral nutrition, artificial respiration, and optimization of the oxygen transport to tissues. Nonetheless, with a certain frequency, these techniques are insufficient to ensure the recovery of a critically ill patient, especially when it is necessary to overcome functional alterations subsequent to organ and vital-system overload. The key elements in the progression of the sepsis-MODS syndrome are tied to numerous factors. These include: the severity and location of the lesion; the patient's age; the remaining functional reserve; and the presence of mediatory which may be stimulatory, inhibitory or both. This overview is aimed at anaesthesiologists and doctors.

The volume focuses on some primary aspects such as the research of the rationale of the immune system activation during sepsis, on the molecular strategies available for ARDS treatment and on techniques of emofiltration and absorption of endotoxins through apheresis in the septic patient.

This volume presents the most recent results of research in the study of sepsis and the new treatments that have become available, mortality rate however still being high. It focuses on the complexity of the several biohumoral factors involved in this process and the consequent organ failure, which grows in a sequential way and in relation with the lesion gravity and the functional reserves of the patient.