SIRS, Sepsis und Multiorganversagen

  • Michael Fresenius
  • Michael Heck


Der Begriff Sepsis stammt aus dem Griechischen und bedeutet Fäulnis (Lewandowski 2002).


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Ausgewählte Literatur

  1. Abraham E et al. for the OPTIMIST Trial Study Group (2003) Efficacy and the safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial. JAMA 290: 238–247PubMedCrossRefGoogle Scholar
  2. Abraham E et al. (1995) Efficacy and safety of monoclonal antibody to human tumor necrosis factor alpha in patients with sepsis syndrome: a randomized, controlled, doubleblind, multicenter clinical trial. JAMA; 273: 934–41PubMedCrossRefGoogle Scholar
  3. Abraham et al. (2005). Drotrecogin alfa (activated) for adults with severe sepsis and low risk of death. N Engl J Med 353: 1332–41PubMedCrossRefGoogle Scholar
  4. Adams HA, Baumann G, Cascorbi I et al. (2005) Empfehlungen zur Diagnostik und Therapie der Schockformen der IAG Schock der DIVI. Teil 5: Septischer Schock. Intensivmed;41:531–543CrossRefGoogle Scholar
  5. Alb M, Hirner S, Luecke Thomas (2007) Critical illness Polyneuropathie und Criticall Illness Myopathy. Anästhesiol Intensivmed Notfallmed Schmerzmed 4: 250–258CrossRefGoogle Scholar
  6. Alberti C, Brun-Buisson C, Buchardi H, Martin J, Goodman S et al. (2002) Epidemiology of sepsis and infection in ICU patients from international multicentre cohort study. Intensive Care Med 28: 108–121PubMedCrossRefGoogle Scholar
  7. Alejandria MM et al. (2002) Intravenous immunoglobuline for treating sepsis and septic shock. (Cochrane Review). The Cochrane Library, Issue 1, OxfordGoogle Scholar
  8. American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) Concensus Conference (1992) Definition for sepsis and multiple organ failure, and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20: 864–874CrossRefGoogle Scholar
  9. Angstwurm et al. (2007). Selenium in Intensive Care: results of a prospective randomized, placebo-controlled, multicenter study in patients with severe systemic inflammatory response syndrome, sepsis and septic shock. Crit Care Med 35: 118–126PubMedCrossRefGoogle Scholar
  10. Angus DC et al. (2003) The RIRO concept: P is for predisposition. Crit Care 7: 248–251PubMedCrossRefGoogle Scholar
  11. Annan D et al. (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288: 862–871CrossRefGoogle Scholar
  12. Annane D, Briegel J, Keh D, Moreno R, Singer M, Sprung CL; The Corticus Study Coordinators (2003) Clinical equipoise remains for issues of adrenocorticotropic hormone administration, cortisol testing, and therapeutic use of hydrocortisone. Crit Care Med 8: 2250–2251CrossRefGoogle Scholar
  13. Ananne et al (2002) Effect of treatment with low doses of hydrocortisone and fludrocortisones on mortality in patients with septic shock. JAMA 288: 862–871CrossRefGoogle Scholar
  14. Annane D, Vignon P, Renault A et al. (2007) Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet; 370:676–684PubMedCrossRefGoogle Scholar
  15. Bauer A, Bruegger D, Christ F. (2005) Mikrozirkulatorisches Monitoring in der Sepsis. Anaesthesist;54:1163–1175PubMedCrossRefGoogle Scholar
  16. Bernard GR et al. (2004) Extended evaluation of recombinant human activated protein C United States Trial (ENHANCE US): a single-arm, phase 3B, multicenter study of drotrecogin alfa (activated) in severe sepsis. Chest 125: 2206–2216PubMedCrossRefGoogle Scholar
  17. Bernard GR et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001; 344: 699–709PubMedCrossRefGoogle Scholar
  18. Bernard GR et al. (1997a) A trial of antioxidants N-acetylcysteine and procysteine in ARDS. Chest 112: 164–72CrossRefGoogle Scholar
  19. Bernard GR et al. (1997) The effects of ibuprofen on the physiology and survival of patients with sepsis. N Engl J Med 336: 912–8PubMedCrossRefGoogle Scholar
  20. Bodmann KF et al. Antimikrobielle Therapie der Sepsis: Chemotherapie Journal 9: 3–23Google Scholar
  21. Bone RC et al. (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 1987;317: 653–8CrossRefGoogle Scholar
  22. Briegel J et al. (1999) Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-centre study. Crit Care Med 27: 723–732PubMedCrossRefGoogle Scholar
  23. Brun-Buisson C (2000) The epidemiology of the systemic inflammatory response. Intensive Care Med 26: 64–74CrossRefGoogle Scholar
  24. Brunkhorst FM, Karzai W, Reinhart K. (2002). Diagnostic approach to sepsis – state of the art. Zentralbl Chir. 127;165–73PubMedCrossRefGoogle Scholar
  25. Brunkhorst FM (2004) Aktuelle Aspekte und Zukunft der Sepsisdiagnose. J Anästhesie Intensivbehandlung 2: 16–17Google Scholar
  26. Carraway MS et al. (2003) Blockade of tissue factor: treatment for organ injury in established sepsis. Am J Respir Crit Care Med 167: 1200–9PubMedCrossRefGoogle Scholar
  27. DeBacker D, Verdant C, Chierego M, Koch M, Gullo A, Vincent J.L. (2006) Effects of drotrecogin alfa activated on microcirculation alterations in patients with severe sepsis. Crit Care Med;34:1918–1924CrossRefGoogle Scholar
  28. Dellinger RP et al. for the surviving Sepsis Campaign Management Guidelines Committee (2004) Surviving Sepsis Campaign guidelines for the management of severe sepsis and septic shock. Crit Care Med 32: 858–872PubMedCrossRefGoogle Scholar
  29. Dellinger RP (2003) Cardiovascular management of septic shock. CCM 31: 946Google Scholar
  30. Docke WD et al. (1997) Monocyte deactivation in septic patients: restoration by IFN-gamma treatment. Nat Med 3: 678–81PubMedCrossRefGoogle Scholar
  31. Fein AM et al. (1997) Treatment of severe systemic inflammatory response syndrome and sepsis with a novel bradykinin antagonist, deltibant (CP-0127): results of a randomized, double-blind, placebo-controlled trial. JAMA 277: 482–7PubMedCrossRefGoogle Scholar
  32. Fisher CJ Jr et al. (1994) Recombinant human interleukin 1 receptor antagonist in the treatment of patients with sepsis syndrome: results from a randomized, doubleblind, placebo-controlled trial. JAMA; 271: 1836–43PubMedCrossRefGoogle Scholar
  33. Forceville et al. (2007) Effects of high dosis of selenium, as sodium selenit, in septic shock: a placebo-controlled, randomized, double-blind, phase II study. Crit Care 11:R 73CrossRefGoogle Scholar
  34. Fourrier F et al. (1992) Septic shock, multiple organ failure, and disseminated intravascular coagulation: compared patterns of antithrombin III, protein C, and protein S deficiencies. Chest;101: 816–23PubMedCrossRefGoogle Scholar
  35. Garlund B. (2006) Aktivated protein C (Xigris) treatment in sepsis: d drug in trouble. Acta Anaesthesiol Scand 50: 525–9CrossRefGoogle Scholar
  36. Gattinoni L, et al. (2003) Sepsis: state of the art Minerva Anesthesiol 69: 539–554Google Scholar
  37. Harbarth et al. (2001) Diagnostic value of procalcitonin, interleukin 6 and interleukin-8 in critically ill patients admitted with suspected sepsis Am J Respir Crit Care Med; 164: 396–402PubMedGoogle Scholar
  38. Hotchkiss RS. (2003) The pathophysiology and treatment of sepsis. N Engl J Med 348: 138–150PubMedCrossRefGoogle Scholar
  39. Hotchkiss et al. (2000) Caspase inhibitors improve survival in sepsis: a critical role of the lymphocyte. Nat Immunol 1: 496–501PubMedCrossRefGoogle Scholar
  40. Keh D et al. (2003) Immunologic and hemodynamic effects of »low-dose« hydrocortisone in septic shock: a doubleblind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med 167: 512–520PubMedCrossRefGoogle Scholar
  41. Klinzing S (2003) High dose vasopressin is not superior to norepinephrine in septic shock. CCM 31: 2646Google Scholar
  42. Kox W et al. (2000) Immunmodulatory therapies in sepsis. Int Care Med 26: 124–128CrossRefGoogle Scholar
  43. Kumar et al. Early antimicrobial therapy in severe sepsis and septic shock. Curr Infect Dis Rep, 12: 336–344Google Scholar
  44. Levy et al. (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. CCM 31: 1250–1256Google Scholar
  45. Lopez A et al. (2004). Multiple-center, randomized, placebocontrolled, double-blind study of the nitric oxide synthase inhibitor 546C88: effect on survival in patients with septic shock. Crit Care Med 32: 21–30PubMedCrossRefGoogle Scholar
  46. Mascias W-L, Yan SB, Williams MD et al. (2005) New insights into the protein C pathway: potential implications for thebiological activities of drotrecogin alfa (activated). Crit Care;9 (Supp. 4):38–45CrossRefGoogle Scholar
  47. Martin GS et al. (2003) The Epidemiology of Sepsis in the United States from 1979 through 2000. New Engl J Med 348: 1546–1554PubMedCrossRefGoogle Scholar
  48. Matot I, Sprung CL (2001) Definition of sepsis. Intensive Care Med 27: 3–9CrossRefGoogle Scholar
  49. Müller-Werdan U, Buerke M, Christoph A et al. Septische Kardiomyopathie. Intensivmed 2006;43:486–497Google Scholar
  50. Nasraway SA (2003) The Problems and Challenges of Immunotherapy in Sepsis. Chest 123: 451–459CrossRefGoogle Scholar
  51. O’Brien A, Clapp L, Singer M (2002) Terlipressin for norepinephrin-resistant septic shock. Lancet 359: 1209–1210PubMedCrossRefGoogle Scholar
  52. Opal S et al. (2004) Recombinant human platelet-activating factor acetylhydrolase for treatment of severe sepsis: results of a phase III, multicenter, randomized, double-blind, placebo-controlled, clinical trial. Crit Care Med 32: 332–41PubMedCrossRefGoogle Scholar
  53. Panacek EA et al. (2000) Neutralization of TNF by an monoclonal antibody improves survival and reduces organ dysfunction in human sepsis: result of the MONARC trial. Chest 118: S88Google Scholar
  54. Patel BM, Chittock DR, Russell JA, Walley KR (2002) Beneficial effects of shortterm vasopressin infusion during severe septic shock. Anesthesiology 96: 576–82PubMedCrossRefGoogle Scholar
  55. Perel A. et al. (2007) Management of Sepsis. NEJM 356: 1178–1182PubMedCrossRefGoogle Scholar
  56. Refresher Course (2008). Aktuelles Wissen für Anästhesisten 34: 139–159Google Scholar
  57. Reinhart K, Menges T, Gardlund B et al. (2001) Randomized, placebo-controlled trial of the anti-tumor necrosis factor antibody fragment afelimomab in hyperinflammatory response during severe sepsis: The RAMSES Study. Crit Care Med 29: 765–769PubMedCrossRefGoogle Scholar
  58. Reinhart K, Bloos F, Engel C, for the German Competence Network. (2006) Hydroxyethylstarch and Ringer`s lactate for fluid resuscitation in patients with severe sepsis – results from the VISEP-Study. Intensive Care Med; 32(1): A818Google Scholar
  59. Reinhart K, Brunkhorst F, Bone HG et al. Diagnose und Therapie der Sepsis. Anaesthesist 2006;55(S1):43–56PubMedCrossRefGoogle Scholar
  60. Reinhart K, et al. Prävention Diagnose, Therapie und Nachsorge der Sepsis (2010). 1. Revision der S-2k-Leitlinien der Deutschen Sepsis-Gesellschaft e.V. (DSG) und der Deutschen interdisziplinären Vereinigung der Intensiv und Notfallmedizin (DIVI). Journal für Anästhesie und Intensivbehandlung II. 2010: 22–59Google Scholar
  61. Rivers E and the Early Goal-directed Therapy Collaborative Group (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. New Engl J Med 354: 1368–1377CrossRefGoogle Scholar
  62. Russell JA (2006) Drug therapy: Management of sepsis. N Engl J Med; 355: 1699–1713PubMedCrossRefGoogle Scholar
  63. Schortgen F et al. (2001) Effects of hydroxyethyl starch and gelatine on renal function in severe sepsis: a multicentre randomised study. Lancet 357: 911–916PubMedCrossRefGoogle Scholar
  64. Sessler CN, Perry JC, Varney KL (2004) Management of severe sepsis and septic shock. Curr Opin Crit Care 10: 354–363PubMedCrossRefGoogle Scholar
  65. SIC-Studie (selenase in intensive care) (2005) Deutscher Anästhesiecongress Pro &Contra-Sitzung: »Selensubstitution bei Sepsis?«. München 16. April 2005Google Scholar
  66. Sprung CL et al. (2001) Guidelines for the management of severe sepsis and septic shock. The international sepsis Forum. Intensive Care Med 27 (Suppl 1): S1–134Google Scholar
  67. Sprung CL et al. (2008). Hydrocortisone therapy for patients with septic shock. N Engl J Med. ;358):111–24PubMedCrossRefGoogle Scholar
  68. Storck M, Hartl WH, Inthorn D. (1991). Septic shock and multiple organ failure: treatmanet with haemofiltration? Intensive Care Med. ;17):372–3PubMedCrossRefGoogle Scholar
  69. Stuber F et al. (1996) A genomic polymorphismus within the tumor necrosis factor locus influences plasma tumor necrosis factor-alpha concentrations and outcome of patients with severe sepsis. Crit Care Med 24: 381–384PubMedCrossRefGoogle Scholar
  70. The International Sepsis Forum (2001) Guidelines for the management of severe sepsis and septic shock. Intensive Care Med 27 (Suppl 1): S1–134Google Scholar
  71. Van de Berghe G et al. (2001) Intensive insulin therapy in critically ill patients. New Engl J Med 345: 1359–1367PubMedCrossRefGoogle Scholar
  72. Van de Berghe G et al. (2003) Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycaemic control. Crit Care Med 31; 359–366PubMedCrossRefGoogle Scholar
  73. Warren BL et al. (2001) High-dose antithrombin III in severe sepsis. A randomized controlled trial. JAMA 286: 1869–1871PubMedCrossRefGoogle Scholar
  74. Weigand M, Bardenheuer H, Böttiger B (2003) Klinisches Management bei Patienten mit Sepsis. Anaesthesist 52: 3–22PubMedCrossRefGoogle Scholar
  75. Welte T (2004) Sepsis management – antibiotic therapy. Dtsch Med Wochenschr. 129:2609–13PubMedCrossRefGoogle Scholar
  76. Wheeler AP et al. (1999) Treating patients with severe sepsis. N Engl J Med 340: 207–214PubMedCrossRefGoogle Scholar
  77. Ziegler EJ et. al. (1991) Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin: a randomized, double-blind, placebo-controlled trial. N Engl J Med 324: 429–36PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Michael Fresenius
    • 1
  • Michael Heck
    • 2
  1. 1.Chefarzt der Klinik für Anästhesie und IntensivmedizinMarienhaus Klinikum Bendorf-Neuwied-WaldbreitbachNeuwied
  2. 2.Facharzt für Anästhesiologie – ambulante Narkosen –Heidelberg

Personalised recommendations