Sepsis--metabolic changes and their development.

As sepsis develops, the patient passes through four stages of haemodynamic and metabolic disturbances. The stages are compensated sepsis, metabolic insufficiency, respiratory insufficiency and cardiac insufficiency. Once the septic process has become uncontrollable, the patient dies in septic shock. On the contrary, all the above stages are potentially reversible if appropriate therapy is instituted. Typical development of the haemodynamic and endocrinologic changes, values of blood gases including metabolites affecting acid base balance as well as changes in the metabolism of carbohydrates, lipids and proteins are described. The article points to aspects that still make accurate sepsis staging difficult.