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Blodforgiftning (sepsis): Årsaker

Sepsis skyldes en bakterieinfeksjon og en betennelsesreaksjon som spres i blodet til mange organer samtidig. Utløsende årsak er ofte en avgrenset infeksjon, for eksempel lungebetennelse, urinveisinfeksjon, hudinfeksjon eller andre infeksjoner. Hva som utløser den kraftige betennelsestilstanden, er knyttet til både bakterien som lager infeksjon og pasientens øvrige helse. Ofte vil dessuten bakteriene kunne påvises i blodbanen.

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Alvorlig underliggende sykdom kan være årsak til utvikling av sepsis. Dette gjelder blant annet pasienter som får store doser cellegift eller immundempende medikamenter, eldre, personer med diabetes, pasienter med alvorlig kreftlidelse, kronisk nyresykdom, kronisk leversykdom, eller immunsykdom. Noen kan utvikle sepsis i forbindelse med kirurgisk behandling.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Sepsis . Referanselisten for dette dokumentet vises nedenfor

  1. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definition for sepsis and septic shock (Sepsis-3). JAMA 2016; 315: 801-10. doi: 10.1001/jama.2016.0287 DOI
  2. American College of Chest Physicians/Society of Critical Care Medicine. Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992; 20: 864-74. PubMed
  3. Flaatten H. Epidemiology of sepsis in Norway in 1999. Critical Care 2004; 8: 180-4. PubMed
  4. Nygård ST, Langaland N, Flaatten HK. Aetiology, antimicrobial therapy and outcome of patients with community acquired severe sepsis: a prospective study in a Norwegian university hospital. BMC Infect Dis 2014; 14: 121. pmid:24588984 PubMed
  5. Statens legemiddelverk. Terapianbefaling: Behandling av sepsis/septisk sjokk. Nytt om legemidler 2004; 27 (nr. 3): 12-20.
  6. Alberti C, Brun-Buisson C, Burchardi H, et al. Epidemiology of sepsis and infection in ICU patients from an international multicenter cohort study. Intensive Care Med 2002; 28: 108-121. PubMed
  7. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003; 348: 1546-54. New England Journal of Medicine
  8. Schroder K, Tschopp J. The Inflammasomes. Cell 2010; 140: 821. pmid:20303873 PubMed
  9. Annane D, Bellissant E, Cavaillon J-M. Septic shock. Lancet 2005; 365: 63-78. PubMed
  10. Biedenbach DJ, Moet GJ, Jones RN. Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997-2002). Diagn Microbiol Infect Dis 2004; 50:59-69. PubMed
  11. Angus DC, van der Poll T. Severe Sepsis and Septic Shock. New Engl J Med 2013; 369: 840. pmid:24256390 PubMed
  12. van der Poll T, Opal SM. Host-pathogen interactions in sepsis. Lancet Infect Dis 2008; 8: 32. pmid:18063412 PubMed
  13. Annane D, Aegerter P, Jars-Guincestre MC, Guidet B. Current epidemiology of septic shock: the CUB-Rea Network. Am J Respir Crit Care Med 2003; 1687: 165-72. PubMed
  14. Freund Y, Lemachatti N, Krastinova E, et al. Prognostic accuracy of Sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA 2017; 317: 301. doi:10.1001/jama.2016.20329 DOI
  15. Fernando SM, Tran A, Taljaard M, et al. Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Mortality in Patients With Suspected Infection: A Systematic Review and Meta-analysis. Ann Intern Med 2018; 168: 266-75. pmid:29404582 PubMed
  16. Dellinger RP, Levy MM, Rhodes A. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Int Care Med 2013; 39: 165. pmid:23361625 PubMed
  17. Karlsson S, Varpula M, Ruokonen E, et al. Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Intensive Care Medicine 2007; 33: 435-43. PubMed
  18. Vesteinsdottir E, Karason S, Sigurdsson SE et al. Severe sepsis and septic shock: a prospective population-based study in Icelandic intensive care units. Acta Anaesthesiol Scand 2011; 55:722-31. PubMed
  19. Nygård ST, Langeland N, Flaatten HK. Aetiology, antimicrobial therapy and outcome of patients with community acquired severe sepsis: a prospective study in a Norwegian university hospital. BMC Infect Dis 2014; 14: 121. pmid:24588984 PubMed
  20. Berild D, Reiso H. Sepsis. Nasjonal retningslinje for antibiotikabruk i primærhelsetjenesten. Lindbæk M (red). Sist oppdatert 03.11.2016
  21. Helsedirektoratet. Sepsis. Nasjonale retningslinjer om antibiotika i sykehus. Sist oppdatert 08. januar 2018. www.helsedirektoratet.no
  22. Uzzan B, Cohen R, Nicolas P, Cucherat M, Perret GY. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 2006; 34: 1996-2003. PubMed
  23. Rivers E, Nguyen B, Havstad S, et al. Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345: 1368-77. New England Journal of Medicine
  24. Mouncey PR, Osborn TM, Power GS. Trial of Early, Goal-Directed Resuscitation for Septic Shock. New Engl J Med 2015; 372: 1301. pmid:25776532 PubMed
  25. Peake SL, Delaney A, Bailey M. Goal-directed resuscitation for patients with early septic shock. New Engl J Med 2014; 371: 1496. pmid:25272316 PubMed
  26. Yealy DM, Kellum JA, Huang DT. A Randomized Trial of Protocol-Based Care for Early Septic Shock. New Engl J Med 2014; 370: 1683. pmid:24635773 PubMed
  27. Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 2004; 350: 2247-56. New England Journal of Medicine
  28. Patel A, Laffan MA, Waheed U, Brett SJ. Randomised trials of human albumin for adults with sepsis: systematic review and meta-analysis with trial sequential analysis of all-cause mortality . BMJ 2014; 349: g4561. BMJ (DOI)
  29. Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006; 34: 1589-96. PubMed
  30. Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for severe sepsis and septic shock: a systematic review and meta-analysis. BMJ 2004; 329: 480. PubMed
  31. Sprung CL, Annane D, Keh D et al. Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008; 358: 111-24. New England Journal of Medicine
  32. Lamontagne F, Rochwerg B, Lytvyn L, et al. Corticosteroid therapy for sepsis: a clinical practice guideline . BMJ 2018; 362: k3284. doi:10.1136/bmj.k3284 DOI
  33. Annane D, Bellissant E, Bollaert PE, et al. Corticosteroids for treating sepsis in children and adults. Cochrane Database Syst Rev. 2019;12:CD002243. doi: 10.1002/14651858 DOI
  34. Fujii T, Luethi N, Young PJ, et al. Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock The VITAMINS Randomized Clinical Trial. JAMA 2020. pmid:31950979 PubMed
  35. Sevransky JE, Rothman RE, Hager DN, et al. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis The VICTAS Randomized Clinical Trial. JAMA 2021; 325: 742-50. pmid:33620405 PubMed
  36. Blomberg B, Flaatten H, Skrede S. Sepsis. Norsk legemiddelhåndbok. Sist endret 27.08.2014.
  37. Capp R, et al. Predictors of patients who present to the emergency department with sepsis and progress to septic shock between 4 and 48 hours of emergency department arrival. Crit Care Med 2015. doi:10.1097/CCM.0000000000000861 DOI
  38. Polderman KH, Girbes ARJ. Drug intervention trials in sepsis: divergent results. Lancet 2004; 363: 1721-23. PubMed
  39. Raith EP, UdyAA, Bailey M,, et al. Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit. JAMA 2017; 317: 290-300. doi:10.1001/jama.2016.20328 DOI
  40. Ranieri VM, Thompson BT, Barie PS, et al. Drotrecogin alfa (activated) in adults with septic shock. N Engl J Med 2012; 366: 2055-64. New England Journal of Medicine
  41. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ ACCP/ ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003; 3: 1250-56. PubMed
  42. Kaukonen K-M, Bailey M, Pilcher D, et al. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med 2015. doi:10.1056/NEJMoa1415236 DOI
  43. Cohen J, Vincent JL, Adhikari NKJ. Sepsis: a roadmap for future research. Lancet Infect Dis 2015; 15: 581. pmid:25932591 PubMed
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