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The role of endotoxin in septic shock.
Kellum, John A; Ronco, Claudio.
Afiliação
  • Kellum JA; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, 600 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA. kellum@pitt.edu.
  • Ronco C; Spectral Medical Inc, Toronto, ON, Canada. kellum@pitt.edu.
Crit Care ; 27(1): 400, 2023 10 19.
Article em En | MEDLINE | ID: mdl-37858258
Septic shock can be caused by a variety of mechanisms including direct effects of bacterial toxins such as endotoxin. Annually, approximately 5-7 million patients worldwide develop sepsis with very high endotoxin activity in the blood and more than half die. The term endotoxic septic shock has been used for these patients but it is important to emphasize that endotoxin may be a factor in all forms of septic shock including non-bacterial etiologies like COVID-19 since translocation of bacterial products is a common feature of septic shock. A pattern of organ failure including hepatic dysfunction, acute kidney injury and various forms of endothelial dysfunction ranging from disseminated intravascular coagulation to thrombotic microangiopathy characterize endotoxic septic shock. However, while characteristic, the clinical phenotype is not unique to patients with high endotoxin, and the diagnosis relies on the measurement of endotoxin activity in addition to clinical assessment. Therapies for endotoxic septic shock are limited with immune modulating therapies under investigation and extracorporeal blood purification still controversial in many parts of the world.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Choque Séptico / Sepse / COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Choque Séptico / Sepse / COVID-19 Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article