J.Jpn. Surg. Soc.. 97(12): 1072-1078, 1996

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Feature topic

RECENT ADVANCES AND TREATMENT OF SEPSIS

This article introduces recent advances in experimental or clinical pathophysiology and in treatment of sepsis. Both the concept of systemic inflammatory response syndrome (SIRS) and the deflnition of sepsis, as the systemic response to infection, have acutally been overwhelming and its generalization is contributing on the better prognosis after treatment for the patients with sepsis and also on the pioneer researches in this field, using molecular biology techniques.
In the mediator network and the immune cell network, cytokines released from polymorphonuclear cells, macrophages, monocytes and vascular endothelial cells have important roles in initiation of the immune cells activations or priminings. On the other hand, free radicals, supecroxides, protelytic enzymes directly involved the pathophysiology, and occasionally impaired the cellular or the organ function. The patient with one or more organ dysfunctions should be cared intensively by multidisciplinary control, i.e. antibacterial therapies, nutritional control, immunomodulation, removal of toxic substances, etc.
Our attentions should be concentrated to prevent from septic MODF, especially for a patient primed by infection, because rapid response atthe second at tack is important for care. Anyhow, fine observation and strict investigation is required for the treatment of the primed patient by infection.

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