الفهرس 
PathophysiologyOnly 14 pages are availabe for public view
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Abstract
Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state (called a systemic inflammatory response syndrome or SIRS) with the presence of a known or suspected infection. Sepsis is associated with three integrated responses: activation of inflammation, activation of coagulation, and impairment of fibrinolysis. These three responses are due to variety of proinflammatory mediators, procoagulant factors, and inhibitors of fibrinolysis.
The imbalance between inflammation, coagulation, and fibrinolysis that occurs in severe sepsis results in systemic inflammation, widespread coagulopathy, and microvascular thrombosis, conditions that can lead to multiple organ dysfunctions.
Sepsis animal models can be divided into non-surgical and surgical models. Non-surgical models include injection of an exogenous toxin and infusion of exogenous bacteria. In surgical models there is an alteration of the animal’s endogenous protective barrier, such as intestinal leakage (e.g., cecal ligation and puncture [CLP] or colon ascendens stent peritonitis [CASP])
An observational study design was achieved to demonstrate the different biochemical, histopathological, and pharmacological parameters in a model of LPS induced sepsis in rats.
As for the treatment of patients with septic shock, it consists of major goals, prophylactic measures, hemodynamic stabilization, adjuvant therapy and prevention and treatment of complications. Resuscitation of the patient from septic shock using early goal directed therapy to correct hypoxia, hypotension, and impaired tissue oxygenation is a corner stone in the treatment. The early goal directed therapy includes fluid therapy, vasopressors and inotropic agents.
Identification and control of the source of infection followed by early start of empirical broad spectrum antimicrobial therapy is highly important in treatment of septic patient. Adjuvant therapy includes anti-inflammatory drugs, antithrombotics, glycemic control and blood products administration. Anti-inflammatory drugs such as corticosteroids are indicated in refractory vasopressor-dependent shock. Drotrecogin alfa is an example of antithrombotics is indicated for severely ill if APACHE II score >25. Tight glycemic control and good parentral nutrition proved to be useful in severly septic patients.
Mechanical ventilation is a measure to treat septic patient complicated with ALI/ARDS.As for renal impairment, renal replacement therapy is indicated in septic patients. H2 blockers or proton pump inhibitors have been used to reduce mucosal damage in patients with severe sepsis to avoid stress ulcers. Septic patients are at high risk of DVT which makes LMWH or heparin to be indicated.