Sepsis: Definitions, Pathophysiology and the Challenge of Bedside Management

271 Pages·2017·5.18 MB·English

by  Nicholas S. Ward

Respiratory Medicine
Series Editor: Sharon I.S. Rounds
Nicholas S. Ward
Mitchell M. Levy Editors
Sepsis
Defi nitions,
Pathophysiology and
the Challenge of
Bedside Management
Respiratory Medicine
Series Editor:
Sharon I.S. Rounds
More information about this series at http://www.springer.com/series/7665
Nicholas S. Ward • Mitchell M. Levy
Editors
Sepsis
Definitions, Pathophysiology
and the Challenge of Bedside Management
Editors
Nicholas S. Ward Mitchell M. Levy
Division of Pulmonary Critical Care, Division of Pulmonary Critical Care,
and Sleep Medicine and Sleep Medicine
Alpert/Brown Medical School Alpert/Brown Medical School
Providence, RI, USA Providence, RI, USA
ISSN 2197-7372 ISSN 2197-7380 (electronic)
Respiratory Medicine
ISBN 978-3-319-48468-6 ISBN 978-3-319-48470-9 (eBook)
DOI 10.1007/978-3-319-48470-9
Library of Congress Control Number: 2017934471
© Springer International Publishing AG 2017
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims
in published maps and institutional affiliations.
Printed on acid-free paper
This Humana Press imprint is published by Springer Nature
The registered company is Springer International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
Sepsis is a disease syndrome that is difficult to understand as well as to treat and has
plagued mankind for thousands of years. In this textbook, the editors and authors
sought to assemble relatively brief but detailed compilations of what is the state of
the science on a variety of key topics. We have chosen topics that range from molec-
ular biology to clinical practice. It is our hope that this text can be used by bench
scientists and clinicians alike as a reference to aid in their work. Clinicians can learn
more about the biology behind the disease they treat and scientists can gain deeper
understanding into how the disease they study plays out in intensive care unit.
Together the clinical and scientific elements of this text will hopefully make a refer-
ence that is of great value. We have picked as authors those who we feel are leaders
in the field they have written about and thus can provide vast experience as well as
data from years of study and practice.
Providence, RI, USA Nicholas S. Ward, MD, FCCM
Providence, RI, USA Mitchell M. Levy, MD, FCCM
v
Contents
Part I
1 Introduction ............................................................................................. 3
Mitchell M. Levy and Nicholas S. Ward
2 Sepsis Definitions..................................................................................... 7
Debasree Banerjee and Mitchell M. Levy
3 Epidemiology of Sepsis: Current Data and Predictions
for the Future .......................................................................................... 25
Bashar Staitieh and Greg S. Martin
Part II
4 Overview of the Molecular Pathways and Mediators of Sepsis .......... 47
Tristen T. Chun, Brittany A. Potz, Whitney A. Young,
and Alfred Ayala
5 Sepsis-Induced Immune Suppression ................................................... 71
Nicholas Csikesz and Nicholas S. Ward
6 Molecular Targets for Therapy .............................................................. 89
Andre C. Kalil and Steven M. Opal
Part III
7 Mechanisms of Organ Dysfunction and Altered
Metabolism in Sepsis............................................................................... 107
Douglas R. Closser, Mathew C. Exline, and Elliott D. Crouser
8 Sepsis-Induced AKI ................................................................................ 127
Hernando Gomez, Alex Zarbock, Raghavan Murugan,
and John A. Kellum
vii
viii Contents
9 Sepsis and the Lung ................................................................................ 143
MaryEllen Antkowiak, Lucas Mikulic, and Benjamin T. Suratt
10 Organ Dysfunction in Sepsis: Brain, Neuromuscular,
Cardiovascular, and Gastrointestinal .................................................... 159
Brian J. Anderson and Mark E. Mikkelsen
Part IV
11 Diagnosis of Sepsis: Clinical Findings and the Role
of Biomarkers .......................................................................................... 187
Daithi S. Heffernan
12 Source Control in Sepsis ......................................................................... 207
Michael Connolly and Charles Adams
13 Hemodynamic Support in Sepsis ........................................................... 219
Jean-Louis Vincent
14 Bundled Therapies in Sepsis .................................................................. 225
Laura Evans and William Bender
15 Genetics in the Prevention and Treatment of Sepsis ............................ 237
John P. Reilly, Nuala J. Meyer, and Jason D. Christie
Index ................................................................................................................. 265
Contributors
Charles Adams, MD Department of Surgery, Alpert/Brown Medical School,
Providence, RI, USA
Brian J. Anderson, MD, MSCE Pulmonary, Allergy and Critical Care Division,
Perelman School of Medicine at the University of Pennsylvania, Philadelphia,
PA, USA
MaryEllen Antkowiak, MD Division of Pulmonary and Critical Care Medicine,
University of Vermont College of Medicine, Burlington, VT, USA
Alfred Ayala, PhD Division of Surgical Research, Department of Surgery, Rhode
Island Hospital, Providence, RI, USA
Debasree  Banerjee, MD Division of Pulmonary, Critical Care, and Sleep
Medicine, Alpert/Brown Medical School, Providence, RI, USA
William Bender Pulmonary, Critical Care and Sleep Medicine, Bellevue Hospital/
NYU School of Medicine, New York, NY, USA
Jason D. Christie Division of Pulmonary, Allergy, and Critical Care Medicine,
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Tristen T. Chun, MD Division of Surgical Research, Department of Surgery,
Rhode Island Hospital, Providence, RI, USA
Douglas  R.  Closser, MD Division of Pulmonary, Critical Care, and Sleep
Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
Michael Connolly, MD Department of Surgery, Alpert/Brown Medical School,
Providence, RI, USA
Elliott D. Crouser, MD Division of Pulmonary, Critical Care, and Sleep Medicine,
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Nicholas Csikesz Alpert Medical School of Brown University, Rhode Island
Hospital, Providence, RI, USA
ix
x Contributors
Laura Evans Pulmonary, Critical Care and Sleep Medicine, Bellevue Hospital/
NYU School of Medicine, New York, NY, USA
Mathew C. Exline, MD Division of Pulmonary, Critical Care, and Sleep Medicine,
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Hernando Gomez, MD The Center for Critical Care Nephrology, University of
Pittsburgh, Pittsburgh, PA, USA
The CRISMA Center, Department of Critical Care Medicine, University of
Pittsburgh, Pittsburgh, PA, USA
Daithi  S.  Heffernan, MD, FACS, AFRCSI Division of Surgical Research,
Department of Surgery, Rhode Island Hospital/Brown University, Providence, RI, USA
Andre  C.  Kalil, MD Infectious Disease Division, Department of Internal
Medicine, University of Nebraska Medical Center, Omaha, NE, USA
John A. Kellum, MD The Center for Critical Care Nephrology, University of
Pittsburgh, Pittsburgh, PA, USA
The CRISMA Center, Department of Critical Care Medicine, University of
Pittsburgh, Pittsburgh, PA, USA
Mitchell M. Levy, MD, FCCM Division of Pulmonary, Critical Care, and Sleep
Medicine, Alpert/Brown Medical School, Providence, RI, USA
Greg S. Martin, MD, MSc Division of Pulmonary, Allergy, and Critical Care
Medicine, Emory University School of Medicine, Atlanta, GA, USA
Nuala J. Meyer Division of Pulmonary Allergy, and Critical Care Medicine,
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Mark E. Mikkelsen, MD, MSCE Pulmonary, Allergy and Critical Care Division,
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA,
USA
Lucas Mikulic, MD Division of Pulmonary and Critical Care Medicine, University
of Vermont College of Medicine, Burlington, VT, USA
Raghavan Murugan, MD The Center for Critical Care Nephrology, University of
Pittsburgh, Pittsburgh, PA, USA
The CRISMA Center, Department of Critical Care Medicine, University of
Pittsburgh, Pittsburgh, PA, USA
Steven M. Opal, MD Infectious Disease Division, Memorial Hospital of RI,
Alpert Medical School of Brown University, Pawtucket, RI, USA
Brittany A. Potz Division of Surgical Research, Department of Surgery, Rhode
Island Hospital, Providence, RI, USA
John P. Reilly Division of Pulmonary, Allergy, and Critical Care Medicine,
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Contributors xi
Bashar Staitieh, MD Division of Pulmonary, Allergy, and Critical Care Medicine,
Emory University School of Medicine, Atlanta, GA, USA
Benjamin T. Suratt, MD Division of Pulmonary and Critical Care Medicine,
University of Vermont College of Medicine, Burlington, VT, USA
Jean-Louis  Vincent, MD Department of Intensive Care, Erasme Hospital,
Université Libre de Bruxelles, Brussels, Belgium
Nicholas S. Ward Division of Pulmonary, Critical Care, and Sleep Medicine,
Alpert/Brown Medical School, Providence, RI, USA
Whitney A. Young Division of Surgical Research, Department of Surgery, Rhode
Island Hospital, Providence, RI, USA
Alex Zarbock Department of Anesthesiology, Intensive Care and Pain Medicine,
University of Münster, Münster, Germany