Updates in management of abdominal sepsis

de Araujo Borges Mirla Fontes, de Sousa Lacerda Roosveni, de Sousa Oliveira Igor, Ferreira Sávio Benvindo
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Abstract

Sepsis is an organ dysfunction caused by a disproportionate host response to infection. The condition is responsible for 1 in every 3 admissions to an intensive care unit (ICU) and about 6 million deaths worldwide. As a result of the imbalance in the inflammatory response, immune dysfunction, mitochondrial damage and other pathophysiological processes, sepsis progresses extremely. This research aimed to search the literature for updates inherent to the therapeutic approach of patients with diseases secondary to intra-abdominal sepsis. The present work is a narrative review with a bibliographical survey carried out in the PUBMED and Virtual Health Library (VHL) research bases, through the search strategy using the following descriptors, in both virtual libraries: “sepsis OR surviving sepsis” AND “intra abdominal infection” AND “therapeutic”. At the end of reading the articles in full, ten papers were selected, from which it was observed that new recommendations regarding volume operative source control, and use of additional therapies therapy. The open abdomen technique is being further explored, as well as more in-depth studies on new drugs for this condition, such as acetylcholinesterase inhibitors, and the use of glucocorticoids became contraindicated, due to low scientific evidence. Therefore, it is concluded that, as it is a medical emergency with high mortality, it is relevant to develop scientific research aimed at the effectiveness, feasibility and safety of new forms of management.
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腹部败血症治疗的最新进展
脓毒症是一种器官功能障碍,由宿主对感染的不成比例的反应引起。重症监护病房(ICU)每3名入院患者中就有1人死于该病,全世界约有600万人死于该病。由于炎症反应失衡、免疫功能紊乱、线粒体损伤等病理生理过程,脓毒症进展极为严重。本研究旨在检索文献,了解腹内败血症继发疾病患者治疗方法的更新。目前的工作是在PUBMED和虚拟健康图书馆(VHL)研究基地进行的文献调查的叙述性回顾,通过使用以下描述符的搜索策略,在两个虚拟图书馆:“败血症或幸存的败血症”和“腹腔内感染”和“治疗”。在全文阅读结束时,选择了10篇论文,从中观察到关于体积、手术源控制和使用额外疗法的新建议。开腹技术正在进一步探索中,针对这种情况的新药如乙酰胆碱酯酶抑制剂的研究也越来越深入,由于科学证据不足,糖皮质激素的使用成为禁忌症。因此,作为一种死亡率高的医疗急症,有必要开展针对新管理形式的有效性、可行性和安全性的科学研究。
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