EVALUATION OF PROGNOSTIC VALUE OF ADHESION MOLECULES IN SEPTIC CRITICALLY ILL PATIENTS

Abstract

Septic shock is the most frequent cause of death in intensi ve care units. Despite major advances in antimicrobial therapy, cri ti ca l care and surgical techniques there has been little impro vement in morbidit y or mortality due to sepsis or septic shock during the past 30 years.

A specific, e1Tective, pharmacologic intervention is still J acking for the extremely complex biochemical and pathophysiologic disorder known as sepsis.

The recruitment of neutrophils to sites of inflammation is initiated by the local production of bacteria-derived attractants, inflammatory cytokines and other host-derived factors. These factors indu ce the rolling of neutrophils on the blood vessel wall followed by finn adhesion and extravasation into thstuTounding infected or infla mmed tissues.

This adherence, both stimulates the leukocytes to perform l ytic functions and allows local concentrations of l ytic med iators secret ed from the effector leukocyte to accumul a te at the le ukocyte/target cell junction.