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THE SEPSIS TEXT This page intentionally left blank THE SEPSIS TEXT edited by Jean-Louis Vincent, M.D. Department of Intensive Care Erasme University Hospital Brussels ,Belgium Jean Carlet, M.D. Service de Réanimation Polyvalente Hôpital Saint-Joseph Paris, France Steven M. Opal, M.D. Division of Infectious Diseases The Memorial Hospital of Rhode Island Pawtucket, RI KLUWER ACADEMIC PUBLISHERS NEW YORK, BOSTON, DORDRECHT, LONDON, MOSCOW eBookISBN: 0-306-47664-9 Print ISBN: 0-7923-7620-X ©2002 Kluwer Academic Publishers NewYork, Boston, Dordrecht, London, Moscow Print ©2002 Kluwer Academic Publishers Dordrecht All rights reserved No part of this eBook maybe reproducedor transmitted inanyform or byanymeans,electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Kluwer Online at: http://kluweronline.com and Kluwer's eBookstore at: http://ebooks.kluweronline.com CONTENTS Contributors xi Introduction JL Vincent,J Carlet,SOpal xix GENERALITIES 1. Sepsis: Themagnitude oftheproblem JL Vincent 1 2. Diagnosis and source of sepsis: The utility of clinical findings KCruz, RPDellinger 11 3. Organ failure R Moreno, RMatos, T Fevereiro 29 4. Markers ofsepsis H. Redl,ASpittler,W Strohmaier 47 5. Genetic predisposition F Stüber 67 6. Quantifyingrisk in sepsis: Areview ofillness severity and organ dysfunction scoring RS Wax,DCAngus, WKnaus 81 vi PATHOPHYSIOLOGY 7. The pathogenesis ofGram-negative sepsis C Papasian, DC Morrison 97 8. The pathophysiology of Gram-positive shock RK Beaton, J Cohen 117 9. Immunopathogenesis of Gram-negative shock SM Opal,CEHubert 135 10. Involvement ofpro- and anti-inflammatory cytokines in sepsis JM Cavaillon,MAdib-Conquy 159 11. Pathophysiology of immunodepression inICUpatients HD Volk, CHöflich, GGrütz, WDDöcke,PReinke 197 12. Pathophysiology ofsepsis: the role ofnitric oxide SJFinney, TWEvans 211 13. Apoptosis and the resolution ofinflammation in sepsis GJ Bellingan 231 14. Microvascular alterations in sepsis AW Sielenkämper, P Kvietys, WJ Sibbald 247 15. Cytopathic hypoxia MP Fink 271 MONITORING SYSTEMS 16. Invasive hemodynamic monitoring E Huettemann, SG Sakka, K Reinhart 285 17. Value of in sepsis T Boulain,JL Teboul 309 vii 18. Blood lactate concentrations in sepsis JA Kruse 323 19. Veno-arterial gradient V Castelain, JL Teboul 339 20. Gas tonometry E Silva, LF Poli de Figueiredo 353 GENERAL SUPPORT 21. Generalhemodynamicsupport SMHollenberg 375 22. Fluid administration ARWebb 389 23. Bloodtransfusionandsepsis DNeilipovitz,PCHébert 401 24. Catecholamine therapy C Martin, JF Dasta, GM Susla 421 25. Regional effects ofcatecholamines AMeier-Hellmann 445 26. Managementofrespiratorydysfunctionin patients with severe sepsis GSMartin, GRBernard 455 27. The roleofnutritionalsupportin sepsis DKHeyland,JKLukan,SAMcClave 479 MICROBIAL ASPECTS 28. The sources ofsepsis C Alberti, C Brun-Buisson 491 viii 29. Catheter-related sepsis JF Timsit 505 30. Control of the source of sepsis JC Marshall 525 31. Empirical antibiotic therapy for patients with severe sepsis and septic shock PY Bochud, MP Glauser, J Carlet, T Calandra 539 32. Candida infections in the intensive care unit JS Solomkin, EJ Anaissie, BB Albair 559 33. Why, when and how to isolate ICU patients B Rubinovitch, P Eggimann, D Pittet 581 COMPLICATIONS 34. The lung in sepsis PM Suter 609 35. The heart in sepsis B Tavernier, A Mebazaa 619 36. The brain in sepsis B Philips, D Bennett 633 37. The gut in sepsis B Vallet 645 38. The kidney in sepsis MG Vervloet, HA Piepot, ABJ Groeneveld 665 39. The coagulation system in sepsis CE Hack 687 ix ANTI-SEPSIS THERAPIES 40. Should fever be treated in sepsis? BACunha 705 41. Anti-cytokine therapy EAbraham 719 42. Heat shockproteins and sepsis: Ahot story JVillar,ASSlutsky 729 43. Immunodepression in the surgical patient and increased susceptibility to infection MK Angele, E Faist 743 44. The place ofcorticosteroids DAnnane,EBellissant 757 45. The place of immunonutrition BLZarzaur, KAKudsk 769 46. Interferencewith the coagulation system LGThijs 787 47. Hemofiltration and plasmapheresis P Rogiers 801 48. Endotoxin analogs in the treatment ofseptic shock MEAstiz 815 49. Vaccines against bacterial endotoxins AKBhattacharjee, AS Cross, SM Opal 827 Index 837
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