Медицинский совет (Jan 2020)

New approaches to the impact on the pathogenetic links of sepsis

  • E. A. Nikitin,
  • K. V. Kleymenov,
  • D. D. Batienco,
  • D. A. Akulenko,
  • P. V. Seliverstov,
  • V. P. Dobritsa,
  • V. G. Radchenko

DOI
https://doi.org/10.21518/2079-701X-2019-21-240-246
Journal volume & issue
Vol. 0, no. 21
pp. 240 – 246

Abstract

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Sepsis is a systemic pathological reaction that arise because of a severe infection. Now, sepsis is considered as one of the most serious diseases and materially expensive nosology’s. For instance, out of 100% of cases of sepsis, only 40% survive. Thus, there is a high mortality rate and a wide prevalence (up to 300 thousand patients with sepsis are registered in Europe), which makes it possible to identify serious problems and the need to improve the clinical approach to the management strategy and tactics of such patients. The number of cases of detection and registration of sepsis has been expanding expansively since the thirties of the last century, and continues to grow dynamically, which obviously requires an improvement in the pathognomonic approach to therapy. The main reasons for the growth of septic conditions are the increasing use of invasive methods in medical practice, the pandemic of diabetes mellitus, the use of cytostatic and immunosuppressants, as well as the increasing number of antibiotic-resistant strains of pathogenic and conditionally pathogenic bacteria, total disruption of mucosal microbiocenoses, unreasonable use of probiotics with production strains containing foci of pathogenicity in patients with primary or secondary immunodeficiencies. Now, the main etiopathogenetic therapy of sepsis remains drugs aimed at the destruction of pathogenic microorganisms. However, based on the pathogenesis of the septic state, it seems effective to search for drugs with new points of application to individual pathogenesis links of the systemic inflammatory response. Today, studies aimed at establishing the effectiveness of influence on any individual links in the pathogenesis of sepsis - inflammatory mediators, have not yet yielded clear results.

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