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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSALOMAO, R.
dc.contributor.authorFERREIRA, B. L.
dc.contributor.authorSALOMAO, M. C.
dc.contributor.authorSANTOS, S. S.
dc.contributor.authorAZEVEDO, L. C. P.
dc.contributor.authorBRUNIALTI, M. K. C.
dc.date.accessioned2019-05-30T13:49:48Z
dc.date.available2019-05-30T13:49:48Z
dc.date.issued2019
dc.identifier.citationBRAZILIAN JOURNAL OF MEDICAL AND BIOLOGICAL RESEARCH, v.52, n.4, article ID e8595, 14p, 2019
dc.identifier.issn0100-879X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/31993
dc.description.abstractSepsis remains a major cause of morbidity and mortality worldwide, with increased burden in low-and middle-resource settings. The role of the inflammatory response in the pathogenesis of the syndrome has supported the modern concept of sepsis. Nevertheless, a definition of sepsis and the criteria for its recognition is a continuous process, which reflects the growing knowledge of its mechanisms and the success and failure of diagnostic and therapeutic interventions. Here we review the evolving concepts of sepsis, from the ""systemic inflammatory response syndrome triggered by infection'' (Sepsis-1) to ""a severe, potentially fatal, organic dysfunction caused by an inadequate or dysregulated host response to infection'' (Sepsis-3). We focused in the pathophysiology behind the concept and the criteria for recognition and diagnosis of sepsis. A major challenge in evaluating the host response in sepsis is to characterize what is protective and what is harmful, and we discuss that, at least in part, the apparent dysregulated host response may be an effort to adapt to a hostile environment. The new criteria for recognition and diagnosis of sepsis were derived from robust databases, restricted, however, to developed countries. Since then, the criteria have been supported in different clinical settings and in different economic and epidemiological contexts, but still raise discussion regarding their use for the identification versus the prognostication of the septic patient. Clinicians should not be restricted to definition criteria when evaluating patients with infection and should wisely use the broad array of information obtained by rigorous clinical observation.eng
dc.description.sponsorshipFAPESP [2017/21052-0]
dc.description.sponsorshipCNPq [305685/2011-2]
dc.language.isoeng
dc.publisherASSOC BRAS DIVULG CIENTIFICAeng
dc.relation.ispartofBrazilian Journal of Medical and Biological Research
dc.rightsopenAccesseng
dc.subjectSepsis-3eng
dc.subjectInflammatory responseeng
dc.subjectImmunometabolismeng
dc.subjectqSOFAeng
dc.subjectSOFAeng
dc.subject.otherinternational consensus definitionseng
dc.subject.otherin-hospital mortalityeng
dc.subject.otherseptic shockeng
dc.subject.othercytokine productioneng
dc.subject.otherhuman monocyteseng
dc.subject.othermitochondrial dysfunctioneng
dc.subject.otherstaphylococcus-aureuseng
dc.subject.otherprognostic accuracyeng
dc.subject.otherclinical-criteriaeng
dc.subject.othermedical progresseng
dc.titleSepsis: evolving concepts and challengeseng
dc.typearticleeng
dc.rights.holderCopyright ASSOC BRAS DIVULG CIENTIFICAeng
dc.identifier.doi10.1590/1414-431X20198595
dc.identifier.pmid30994733
dc.subject.wosBiologyeng
dc.subject.wosMedicine, Research & Experimentaleng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
hcfmusp.author.externalSALOMAO, R.:Univ Fed Sao Paulo, Disciplina Infectol, Escola Paulista Med, Sao Paulo, SP, Brazil
hcfmusp.author.externalFERREIRA, B. L.:Univ Fed Sao Paulo, Disciplina Infectol, Escola Paulista Med, Sao Paulo, SP, Brazil
hcfmusp.author.externalSANTOS, S. S.:Univ Fed Sao Paulo, Disciplina Infectol, Escola Paulista Med, Sao Paulo, SP, Brazil
hcfmusp.author.externalAZEVEDO, L. C. P.:Hosp Sirio Libanes, Unidade Terapia Intens, Sao Paulo, SP, Brazil
hcfmusp.author.externalBRUNIALTI, M. K. C.:Univ Fed Sao Paulo, Disciplina Infectol, Escola Paulista Med, Sao Paulo, SP, Brazil
hcfmusp.description.articlenumbere8595
hcfmusp.description.issue4
hcfmusp.description.volume52
hcfmusp.origemWOS
hcfmusp.origem.idWOS:000464667000001
hcfmusp.origem.idSCIELO:S0100-879X2019000400301
hcfmusp.origem.id2-s2.0-85064993630
hcfmusp.publisher.cityRIBEIRAO PRETOeng
hcfmusp.publisher.countryBRAZILeng
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