Markeri sepse

master's thesis

• Title (english): Markers of sepsis
• Author: Filip Žigman
• Mentor: Slobodan Mihaljević (mentor)
• Committee member: Željko Čolak (predsjednik povjerenstva)
• Committee member: Dinko Tonković (član povjerenstva)
• Committee member: Slobodan Mihaljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Intensive Care

Abstract

Sepsa je životno ugrožavajuća disfunkcija organa uzrokovana neprimjerenim odgovorom domaćinovog organizma na infekciju koja godišnje odnosi između 5 i 11 milijuna života. Usprkos velikom napretku u razumijevanju patofizioloških procesa koji dovode do razvoja ovoga teškog stanja, malo toga se promijenilo u procesu postavljanja dijagnoze i liječenja septičnih bolesnika. Naime, najboljom terapijom se i dalje smatra ona koja se započne pravovremeno odnosno što brže nakon pojave sumnje na sepsu. Pri tome, vrlo je važna uloga potencijalnih markera sepse koje definiramo kao bilo koju tvar, strukturu ili proces koji se može izmjeriti u tijelu ili njegovim proizvodima te utjecati ili predvidjeti incidenciju ishoda ili bolesti. Veliki napori ulažu se zadnjih desetljeća u traženje ubikvitarne, pouzdane, brze i jeftine metode koja će dovoljno rano opravdati sumnju liječnika na sepsu i omogućiti brzu intervenciju. Od tih metoda se očekuje da mogu potvrditi ili isključiti sepsu, procijeniti težinu stanja i ishod bolesti te pomoći u primjeni terapije, ponajprije one antibiotske. Zasada je identificirano preko 170 potencijalnih markera, ali samo neki od njih su se uspjeli pokazati korisnima u kliničkoj praksi. Uvodnih pet poglavlja prikazuje dosadašnje spoznaje i pruža kontekst o težini i veličini globalnog problema kojeg nazivamo sepsom. U drugome dijelu ovoga rada diskutira se o upotrebi markera koji se već nalaze u svakodnevnoj kliničkoj primjeni, kao i onih koji se koriste u specifičnim situacijama poput novorođenačke sepse ili procjeni razvoja imunosupresivne faze septičnog odgovora te markera čija se zasada obećavajuća dijagnostička i prognostička moć tek još mora u potpunosti dokazati.

Abstract (english)

Sepsis is a life-threatening organ dysfunction caused by an inappropriate response by the host organism to an infection that causes 5 to 11 million deaths per year. Despite great advances in understanding the pathophysiological processes that lead to the development of this difficult condition, little has changed in the process of diagnosing and treating septic patients. Namely, the best therapy is still considered to be the one that is started on time or as soon as possible after the appearance of suspected sepsis. In doing so, the role of potential markers of sepsis is very important, which we define as any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease. Great efforts have been made in recent decades to find a ubiquitous, reliable, fast and cheap method that will justify doctors' suspicion of sepsis early enough and enable rapid intervention. These methods are expected to be able to confirm or rule out sepsis, assess the severity of the condition and the outcome of the disease, and assist in the application of therapy, primarily antibiotics. So far, over 170 potential markers have been identified, but only some of them have been shown to be useful in clinical practice. The introductory five chapters present the findings to date and provide a context on the severity and magnitude of the global problem we call sepsis. The second part of this paper discusses the use of markers already in everyday clinical use, as well as those used in specific situations such as neonatal sepsis or assessing the development of the immunosuppressive phase of the septic response, and markers whose promising diagnostic and prognostic power still must be fully proven.

• Keywords: sepsa; markeri sepse; hematološki markeri; reaktanti akutne faze; citokinski markeri
• Keywords (english): sepsis; markers of sepsis; hematological markers; acute phase reactants; cytokine markers
• Language: croatian
• URN:NBN: urn:nbn:hr:105:324783
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-06-07 07:50:18