Sepsis and Multiple Organ Failure: Pathogenesis and Treatment

Abstract

Sepsis is clearly recognized as the leading cause of death in intensive care units today [1]. This is true if the patient is admitted with an infection as the primary diagnosis or if the infection is an intercurrent complication of another reason for admission, such as shock or trauma. This problem is particularly evident in the postoperative patient. In these patients there is not only an increased susceptibility for infection because of the effects of anesthesia, open wounds, involvement of the gastro-intestinal tract and the immunosuppressive potential of the operative trauma itself and any blood transfusion which may be required. There is also greater difficulty in the detection of postoperative infection. This is made more difficult by the pain of the incision, the radiographic changes in the lung secondary to atelectasis and the metabolic effects of stress which can cause fever and leukocytosis even in the absence of infection.