Articles: sepsis.
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Critical care clinics · Jul 1989
ReviewMultiple systems organ failure (MSOF): lessons learned from the adult respiratory distress syndrome (ARDS).
The relationship between ARDS and MSOF is explored. Models include that ARDS represents only one organ failing in MSOF, or that MSOF is a complication of ARDS owing to the development of infection and sepsis syndrome in these patients. Data are reviewed suggesting an important role of infection and sepsis syndrome in both models.
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Case Reports
[Fulminant sepsis following posttraumatic splenectomy--OPSI (overwhelming postsplenectomy infection) syndrome].
We report a case of fulminant sepsis 10 years after posttraumatic splenectomy. The low-cardiac-output stage of the septic shock with disseminated intravascular coagulation (DIC), which was already marked on admission to the intensive care unit, could not be overcome despite appropriate shock treatment. The pathogenetic spectrum includes more than 70% pneumococci, but any pathogen can trigger an overwhelming postsplenectomy infection (OPSI) syndrome. ⋯ An emergency passport is appropriate. 4. In view of the few side effects of the vaccine, all splenectomized patients should be immunized against pneumococci. Children under 2 years of age should furthermore receive prophylactic oral penicillin up to the age of 5.
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Within a 3-years period the presence of nosocomial bacteriaemias was analyzed retrospectively among 13.878 hospitalized patients. The incidence was 0.050%. Antibiotic prophylaxis and the operative technique play an important role in achieving a low incidence of morbidity due to infection. The management of a severe infection includes antibiotic therapy according to culture sensitivity and intensive care.