الفهرس 
Pathophysiology of sepsisOnly 14 pages are availabe for public view
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Abstract
Severe sepsis is defined as presence or presumed presence of an infection accompanied by evidence of a systemic inflammatory response syndrome. Severe sepsis occurs in 1-2 of all hospitalizations and accounts for as much as 25% of ICU bed utelization. Causes include infectious and noninfectious causes. Inflammation is just one of many contributors to septic physiology; other factors include enhanced coagulation and impaired fibrinolysis.
Primary assessment of septic patient is carried out while resuscitating the patient and secondary assessment focus on the different organs affection. Preoperative investigations , monitoring source control together with correction of electrolyte and acid base disturbance are essential to improve the outcome .Optimization of major organ perfusion is based on judicious use of fluids , vasopressors and inotropes. The challenge in the care of eeptic patient is to support treatment goals and prevent added complications including stress ulcer, DVT , aspiration pneumonia and progression to MODS.
For the septic patient taken to surgery, death is a possible reality, not a rare chance. The decision to bring a septic patient to the operating room can be difficult. It requires the conviction that the planned intervention will correct an otherwise unacceptable trajectory. Intraoperative management requires careful induction of anesthesia, using lowest effective doses of a range of agents. Maintenance of anesthesia is challenging, requiring achievement of optimal volume status, avoidance of lung injury during mechanical ventilation, and ongoing monitoring of arterial blood gases, hematological and renal indices, and electrolyte levels.
Postoperative care overlaps with ongoing management of the severe sepsis syndrome patient in the ICU. The care of critically ill septic patients requiring anesthesia and surgery will be further enhanced by testing promising therapeutic strategies.