Ziesmann Markus T, Marshall John C
Departments of Surgery and Critical Care Medicine, St. Michael's Hospital, University of Toronto , Toronto, Ontario, Canada .
Surg Infect (Larchmt). 2018 Feb/Mar;19(2):184-190. doi: 10.1089/sur.2017.298. Epub 2018 Jan 23.
Sepsis as a process has been recognized since the time of the Ancient Greeks. The concept has evolved recently to reflect a disease process of a severe, systemic response to infection. Acute, life-threatening but potentially reversible organ dysfunction is its hallmark, and unresolving organ dysfunction is the dominant cause of death in critical illness. Its evolution, persistence, and resolution reflect a complex interplay of factors originating in the initial inciting insult, the innate immune and metabolic response of the host, and the beneficial and harmful consequences of intensive care unit (ICU) supportive care.
We describe the common clinical manifestations of the six prototypic organ system dysfunction syndromes of severe sepsis and review the associated epidemiology and suspected pathophysiology.
脓毒症作为一种病症，自古希腊时期就已被认识。该概念最近有所演变，以反映对感染的严重全身性反应的疾病过程。急性、危及生命但可能可逆的器官功能障碍是其标志，而持续存在的器官功能障碍是危重病死亡的主要原因。其演变、持续和缓解反映了源于初始激发性损伤、宿主的固有免疫和代谢反应以及重症监护病房（ICU）支持治疗的有益和有害后果等多种因素的复杂相互作用。
我们描述了严重脓毒症六种典型器官系统功能障碍综合征的常见临床表现，并综述了相关的流行病学及可疑的病理生理学。
