Mehta Yatin, Paul Rajib, Rabbani Raihan, Acharya Subhash Prasad, Withanaarachchi Ushira Kapilani
Institute of Critical Care and Anesthesiology, Medanta the Medicity, Sector-38, Gurugram 22001, India.
Internal Medicine, Apollo Hospitals, Road Number 72, Jubilee Hills, Hyderabad 500033, India.
J Clin Med. 2022 Jun 23;11(13):3635. doi: 10.3390/jcm11133635.
Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.
脓毒症是一种危及生命的病症,会造成与高死亡率和高发病率相关的全球健康负担。脓毒症通常危及生命,可由细菌、病毒、寄生虫或真菌引起。脓毒症的管理主要侧重于源头控制、早期使用广谱抗生素以及器官功能支持。我们管理脓毒症患者方式的全面变革包括早期识别、感染源识别以及立即进行抗菌治疗、适当的支持性护理和血流动力学优化。尽管三十多年来进行了所有临床和实验研究,但对该疾病预后产生积极影响的能力仍然有限。这可能是由于发展中国家,尤其是东南亚地区关于脓毒症的研究有限。本综述总结了东南亚地区在脓毒症诊断及相关时间、黏菌素耐药性和氯霉素益处、抗生素滥用、资源限制以及脓毒症与新冠病毒病关联方面取得的进展。个性化方法以及诸如细胞吸附疗法等创新治疗选择被强调为东南亚地区脓毒症患者治疗的潜在选择。