Management of Sepsis

by Rello, Jordi; Diaz, Emili; Rodriguez, Alejandro

• ISBN13: 9783642004780
• ISBN10: 3642004784
• Edition: 1st
• Format: Hardcover
• Copyright: 2009-07-01
• Publisher: Springer Verlag

Summary

Sepsis is a very important public health problem. It is widely acknowledged that the severe inflammatory response syndrome/severe sepsis paradigm fails to stratify sepsis patients adequately. This book reviews in detail how sepsis should be managed on the basis of a novel approach to staging. The PIRO (predisposing factors, infection, response, organ dysfunction) model was first proposed at the start of the decade on a theoretical basis and has now been translated into a practical approach for use at the bedside. It is loosely based on the TNM staging system for cancers, with points being allocated to each of the four aforementioned key characteristics of the septic process. The proposed PIRO framework facilitates evaluation of factors that are important in the pathogenesis of severe sepsis and in the development of treatment strategies. This book clearly explains the advantages of the PIRO approach in different settings and will be of value to all practitioners concerned with the management of sepsis.

Table of Contents

PIRO: The Key to Success?	p. 1
Risk Stratification in Severe Sepsis: Organ Failure Scores or PIRO?	p. 11
Community-Acquired Pneumonia Management Based on the PIRO System. A New Therapeutic Paradigm	p. 23
Ventilator-Associated Pneumonia PIRO Score	p. 39
A PIRO-Based Approach for Severity Assessment in Community-Acquired Pneumonia	p. 51
Real-Time PCR in Microbiology: From Diagnosis to Characterization	p. 65
Influence of Serotype in Pneumococcal Disease: A New Challenge for Vaccination	p. 87
Acute Kidney Injury and Extracorporeal Blood Purification in Sepsis	p. 97
Immunoglobulin, Sepsis, and Pneumonia	p. 117
Coagulation Disorders in Sepsis	p. 131
Antibiotics in Severe Sepsis: Which Combinations Work?	p. 147
Index	p. 159
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