Elucidation of the role of Endothelium Barrier Protectors and Cytokines in Sepsis

Abstract

Sepsis is defined as a generalized inflammatory host response to the infectious newlineagent and often manifest as the systemic inflammatory response syndrome (SIRS). newlineAmerican College of Chest Physicians (ACCP) and Society of Critical Care Medicine newline(SCCM) defined sepsis as the presence of proven or suspected infection with two newlineor more of the SIRS criteria (Bone et al., 1992). These SIRS criteria include newlinealterations in physiological parameters such as temperature, heart rate, newlinerespiratory rate etc. (Table 2.1). For the management of sepsis, recent Surviving newlineSepsis Campaign (SSC) guidelines recommended administration of antibiotics newlinewithin 1 hour of septic shock onset, (Dellinger et al., 2013) as every hour of the newlinedelay in antibiotic administration demonstrated an increase in mortality of 7.6% newlinein septic shock (Kumar et al., 2006). newlineTherefore, sepsis is a medical emergency, where every hour of the delay in newlinetreatment matters. newlineSepsis remains a life threatening medical condition that has challenged the health newlinecare system globally. Originally, some 2000 years back, Hippocrates used this newlineGreek term, which means putrefaction and organic matter decomposition to newlinedescribe a process of flesh rot (Majno, 1991; Geroulanos et al., 2006). This newlinecondition has puzzled researchers and clinicians throughout history. Initially, it newlinewas defined as a systemic infection response due to invasion of pathogenic little newlinecreatures invisible to eye called microbes. As the microbes were thought newlineresponsible for the disease, breakthrough discovery of antibiotics appeared as a newlinehope. Though institution of antibiotics to such patients helped, it did not solve the newlineproblem fully. Later, it was suggested that the host, not the pathogen itself is newlineresponsible for the poor outcome in sepsis (Cerra, 1985). During the last decade, newlinevarious epidemiological studies have reported an increase in the incidence of newlinesepsis across the world (Martin et al., 2003; Engel et al., 2007; Blanco et al., 2008).