الفهرس 
General Principles of Sepsis.Only 14 pages are availabe for public view
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Abstract
Sepsis is the systemic response to infection, thus, in sepsis, the clinical signs describing SIRS are present together with definitive evidence of infection, severe sepsis is considered severe when it is associated with organ dysfunction, hypoperfusion, or hypotension.
Sepsis is the culmination of complex interactions between the infecting microorganism and the host immune, inflammatory, and coagulation responses through proinflammatory mediators like interleukins and tumor necrosis factor (TNF) and platelets activating factor and nitric oxide which leads to endothelial damage and micro circulatory impairment.
Also Mitochondrial oxidative stress and dysfunction due to generation of ROS occur at uncontrolled rate causing oxidation to proteins and lipids which leads to damaged of endogenous antioxidant systems and outer membrane permeabilization (MOMP), leading to apoptosis impaired oxygenation at cellular level(cell cytopathy).
Although there are a lot of trials to reach to early management of severe sepsis and also put standard medical protocol for early resuscitation and tight control of severs sepsis still there is high rate of fail in control of disease through standard treatment.
So there are extensive studies for novel therapies as adjutants to standared treatment
N-acetylcysteine (NAC) is one of the most extensively studied antioxidants, NAC is a safe drug with a wide toxic–therapeutic window
Many potentially beneficial and protective effects of NAC have been demonstrated in endotoxic and septic conditions, as a thiol-containing compound, NAC scavenges free oxygen radicals and replenishes depleted body glutathione stores, NAC also suppresses the activation of neutrophils and macrophages and, attenuates leukocyte–endothelial cell adhesion and capillary leakage, and blocks the release of tumour necrosis factor alpha
In our study we evaluate the effect of early use of n-acetylcysteine infusion in severe sepsis on micro-albuminurea, intramucosal gastric p.H, inflammatory processes by investigate Gastric tonometry ,C-Reactive protein, WBC count and tumor necrosis factor-Alpha.