RAZVOJ DEFINICIJE SEPSE

Nemanja Dimić; Marko  Đurić; Irina Nenadić; Marina Boboš; Suzana Bojić; Tatjana Vukotić; Mirjana Simeunović Gojgić; Milan Gojgić; Predrag Stevanović; Ksenija Bojović

doi:10.5937/smclk4-42608

Nemanja Dimić KBC "Dr Dragiša Mišović"
Marko Đurić KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija; Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija
Irina Nenadić KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija; Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija
Marina Boboš KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija
Suzana Bojić KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija; Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija
Tatjana Vukotić KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija
Mirjana Simeunović Gojgić Gradski zavod za javno zdravlje, Beograd, Srbija
Milan Gojgić KBC „Bežanijska kosa“, Beograd, Srbija
Predrag Stevanović KBC „Dr Dragiša Mišović – Dedinje“, Beograd, Srbija; Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija
Ksenija Bojović Univerzitet u Istočnom Sarajevu, Medicinski fakultet Foča, Republika Srpska

DOI: https://doi.org/10.5937/smclk4-42608

Ključne reči: sepsa, definicija, mortalitet

Sažetak

Sepsa predstavlja veliki zdravstveni problem, imajući u vidu da svake godine preko 20 miliona ljudi u svetu oboli od sepse. Uprkos značajnom razvoju medicine poslednjih decenija, stopa mortaliteta sepse je izuzetno visoka (oko 26%). Razvoj definicije sepse tekao je uporedo sa razumevanjem mehanizma nastanka sepse. Početkom devedesetih godina dvadesetog veka nastala je prva definicija sepse, prema kojoj je sepsa definisana kao sindrom sistemskog inflamatornog odgovora (engl. systemic inflammatory response syndrome – SIRS), uz prisustvo sumnje ili dokaza o postojanju infekcije. Zbog velikog broja neadekvatno dijagnostikovanih pacijenata sa sepsom nastala je druga definicija, po kojoj je sepsa definisana kao klinički sindrom. Zbog nedovoljne preciznosti prethodnih definicija sepse, ali i novih saznanja o patofiziološkom mehanizmu sepse, 2016. godine je nastala i treća definicija sepse. Prema ovoj definiciji, sepsa je životno ugrožavajuće stanje u čijoj osnovi se nalazi organska disfunkcija nastala kao posledica neadekvatnog odgovora organizma na infekciju. Septički šok se manifestuje cirkulatornom, ćelijskom i metaboličkom nestabilnošću i karakteriše se nivoom laktata u serumu većim od 2 mmol/l i prisutnom hipotenzijom, koja nakon primene intravenskih rastvora, zahteva terapiju vazopresorima. Ova definicija sepse i septičkog šoka omogućava rano prepoznavanje i lečenje bolesnika sa sepsom, što su ključni koraci u smanjenju incidencije i mortaliteta od ove bolesti.

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