Persistent Organ Dysfunction after Severe Sepsis

Abstract

Organ dysfunction is the commonest complication followed severe sepsis and the commonest cause of mortality in septic patients. Recent studies discuss theories of pathogenesis of severe sepsis and organ dysfunction. The role of immune response has become clearer and we realized that sepsis is in fact a host response to the invading micro-organism rather than any specific feature of the micro-organism itself. These studies have become a base for understanding disease and organ dysfunction as a complication and studying the effect of early and efficient management to improve outcomes of sepsis. Despite initial enthusiasm about “disease-modifying agents” the early administration of appropriate antibiotics and early hemodynamic resuscitation remain the cornerstone of the management of patients with sepsis and improvement of outcomes. Survivors of sepsis often suffer significant resultant morbidity, including "organ dysfunction". However, little is known about persistent or long-term organ dysfunction in this patient population. Persistent organ dysfunction is defined as continued dysfunction between 28 and 90 days from the initial septic insult.