Cargando…

Sepsis and pregnancy: do we know how to treat this situation?

Sepsis is defined as an acute inflammatory response syndrome secondary to an infectious focus. It has a high incidence, morbidity and mortality, causing substantial financial costs, especially due to complications such as septic shock and multiple organ dysfunction. The pathogen toxins associated wi...

Descripción completa

Detalles Bibliográficos
Autores principales: Cordioli, Ricardo Luiz, Cordioli, Eduardo, Negrini, Romulo, Silva, Eliezer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Brasileira de Medicina intensiva 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031877/
https://www.ncbi.nlm.nih.gov/pubmed/24553516
http://dx.doi.org/10.5935/0103-507X.20130056
_version_ 1782317579013980160
author Cordioli, Ricardo Luiz
Cordioli, Eduardo
Negrini, Romulo
Silva, Eliezer
author_facet Cordioli, Ricardo Luiz
Cordioli, Eduardo
Negrini, Romulo
Silva, Eliezer
author_sort Cordioli, Ricardo Luiz
collection PubMed
description Sepsis is defined as an acute inflammatory response syndrome secondary to an infectious focus. It has a high incidence, morbidity and mortality, causing substantial financial costs, especially due to complications such as septic shock and multiple organ dysfunction. The pathogen toxins associated with individual susceptibility culminate with cytokine release, which promotes a systemic inflammatory response that can progress to multiple organ dysfunction and eventual patient death. Specifically, sepsis incidence, morbidity and mortality are lower in pregnant women, as this group is typically younger with fewer comorbidities having a polymicrobial etiology resulting in sepsis. Pregnant women exhibit physiological characteristics that may confer specific clinical presentation and laboratory patterns during the sepsis course. Thus, a better understanding of these changes is critical for better identification and management of these patients. The presence of a fetus also requires unique approaches in a pregnant woman with sepsis. Sepsis treatment is based on certain guidelines that were established after major clinical trials, which, unfortunately, all classified pregnancy as a exclusion criteria. Thus, the treatment of sepsis in the general population has been extrapolated to the pregnant population, with the following main goals: maintenance of tissue perfusion with fluid replacement and vasoactive drugs (initial resuscitation), adequate oxygenation, control of the infection source and an early start of antibiotic therapy, corticosteroid infusion and blood transfusion when properly indicated, prophylaxis, and specifically monitoring and maintenance of fetal heath.
format Online
Article
Text
id pubmed-4031877
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Associação Brasileira de Medicina intensiva
record_format MEDLINE/PubMed
spelling pubmed-40318772014-06-02 Sepsis and pregnancy: do we know how to treat this situation? Cordioli, Ricardo Luiz Cordioli, Eduardo Negrini, Romulo Silva, Eliezer Rev Bras Ter Intensiva Review Article Sepsis is defined as an acute inflammatory response syndrome secondary to an infectious focus. It has a high incidence, morbidity and mortality, causing substantial financial costs, especially due to complications such as septic shock and multiple organ dysfunction. The pathogen toxins associated with individual susceptibility culminate with cytokine release, which promotes a systemic inflammatory response that can progress to multiple organ dysfunction and eventual patient death. Specifically, sepsis incidence, morbidity and mortality are lower in pregnant women, as this group is typically younger with fewer comorbidities having a polymicrobial etiology resulting in sepsis. Pregnant women exhibit physiological characteristics that may confer specific clinical presentation and laboratory patterns during the sepsis course. Thus, a better understanding of these changes is critical for better identification and management of these patients. The presence of a fetus also requires unique approaches in a pregnant woman with sepsis. Sepsis treatment is based on certain guidelines that were established after major clinical trials, which, unfortunately, all classified pregnancy as a exclusion criteria. Thus, the treatment of sepsis in the general population has been extrapolated to the pregnant population, with the following main goals: maintenance of tissue perfusion with fluid replacement and vasoactive drugs (initial resuscitation), adequate oxygenation, control of the infection source and an early start of antibiotic therapy, corticosteroid infusion and blood transfusion when properly indicated, prophylaxis, and specifically monitoring and maintenance of fetal heath. Associação Brasileira de Medicina intensiva 2013 /pmc/articles/PMC4031877/ /pubmed/24553516 http://dx.doi.org/10.5935/0103-507X.20130056 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Cordioli, Ricardo Luiz
Cordioli, Eduardo
Negrini, Romulo
Silva, Eliezer
Sepsis and pregnancy: do we know how to treat this situation?
title Sepsis and pregnancy: do we know how to treat this situation?
title_full Sepsis and pregnancy: do we know how to treat this situation?
title_fullStr Sepsis and pregnancy: do we know how to treat this situation?
title_full_unstemmed Sepsis and pregnancy: do we know how to treat this situation?
title_short Sepsis and pregnancy: do we know how to treat this situation?
title_sort sepsis and pregnancy: do we know how to treat this situation?
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031877/
https://www.ncbi.nlm.nih.gov/pubmed/24553516
http://dx.doi.org/10.5935/0103-507X.20130056
work_keys_str_mv AT cordioliricardoluiz sepsisandpregnancydoweknowhowtotreatthissituation
AT cordiolieduardo sepsisandpregnancydoweknowhowtotreatthissituation
AT negriniromulo sepsisandpregnancydoweknowhowtotreatthissituation
AT silvaeliezer sepsisandpregnancydoweknowhowtotreatthissituation