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Hello. This talk is on sepsis.
I'm John Kellum from the
University of Pittsburgh.
0:09
The term sepsis dates back
to antiquity when it was
understood to be the process
by which flesh rots,
wounds fester, and swamps
produce foul odors.
In the 19th century,
thanks to the work
by Pasteur, Pfeiffer, Koch,
and others, germ
theory took hold,
and sepsis was understood
to be due to
systemic infections,
and terms like blood poisoning
and septicemia
were also invoked.
In the modern era, thanks
to the work by Beutler, Hoffman,
and many others,
molecular biology
has unraveled many of
the mysteries of sepsis.
Pathogen-associated molecular
patterns, or PAMPs,
and damage-associated
molecular patterns, or DAMPs,
were discovered to signal
the immune system through
pattern recognition receptors,
most notably
Toll-like receptors.
Furthermore, consensus
definitions,
though still evolving,
have come to view sepsis
as an uncontrolled host
response to infection.
1:07
The clinical
criteria for sepsis,
according to the most
recent definition of sepsis
the Sepsis-3 Criteria,
which were derived by
international consensus,
defines sepsis as a
life-threatening organ dysfunction
caused by a dysregulated
host response to infection.
This can be operationalized
using organ failure scores such
as the Sequential Organ Failure
Assessment score, SOFA.
The change of 2 or more points
is considered to
fulfill the definition.
Importantly, this change
in organ function
should be consequent
to infection
and not caused by
something else.
It should be remote from
the site of infection
so that local infection itself
causing organ failure is
not evidence of a dysregulated
systemic hos response.
For example,
respiratory failure,
secondary to pneumonia
does not in and of itself
fulfill the criteria for sepsis.
