SEPSIS – AN ONGOING AND SIGNIFICANT CHALLENGE Edited by Luciano Azevedo Sepsis – An Ongoing and Significant Challenge http://dx.doi.org/10.5772/2958 Edited by Luciano Azevedo Contributors Johan Sebastián Hernández Botero, María Cristina Florián Pérez, Safiah Mai, Momina Khan, Patricia Liaw, Alison Fox-Robichaud, Neville Azzopardi, Manuel Fenech, Tonio Piscopo, Ayse Belin Ozer, Mustafa Bayar, Peixin Huang, Ding You Li, Daniel P. Heruth, Li Qin Zhang, Dmitry N. Grigoryev, Shui Qing Ye, Ricardo Fernandez, Claudio Acuña-Castillo, Zeljko Lausevic, Mirjana Lausevic, Lixin Xie, Aristotelis Perrakis, Volker Müller, Werner Hohenberger, Roland S. Croner, Radha Swathe Priya M., Emma P. Córcoles, Bernhard Resch, Nora Hofer, Wilhelm Müller, C. Savagner, B. Leboucher, G. Gascoin-Lachambre, C. Gras-Leguen, Efraín Riveros Pérez, Marilynn R. Fairfax, Hossein Salimnia, Andries William Dreyer, Renato Finkelstein, Ilana Oren, Rekha Chandran, Morgan Hakki, Stephen Spurgeon, F.J. García-Miguel, Marie Mullen Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Mirna Cvijic Typesetting InTech Prepress, Novi Sad Cover InTech Design Team First published September, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Sepsis – An Ongoing and Significant Challenge, Edited by Luciano Azevedo p. cm. ISBN 978-953-51-0780-4 Contents Preface IX Section 1 History of Sepsis 1 Chapter 1 The History of Sepsis from Ancient Egypt to the XIX Century 3 Johan Sebastián Hernández Botero and María Cristina Florián Pérez Section 2 Sepsis Pathophysiology and Animal Studies 33 Chapter 2 Experimental Sepsis Models 35 Safiah Mai, Momina Khan, Patricia Liaw and Alison Fox-Robichaud Chapter 3 Sepsis, the Liver and the Gut 71 Neville Azzopardi, Manuel Fenech and Tonio Piscopo Chapter 4 Nerve Growth Factor and Sepsis 105 Ayse Belin Ozer and Mustafa Bayar Chapter 5 Nicotinamide Phosphoribosyltransferase in Sepsis 119 Peixin Huang, Ding You Li, Daniel P. Heruth, Li Qin Zhang, Dmitry N. Grigoryev and Shui Qing Ye Chapter 6 Neural Reflex Control of Inflammation During Sepsis Syndromes 133 Ricardo Fernandez and Claudio Acuña-Castillo Section 3 Biomarkers in Sepsis 157 Chapter 7 Early Detection of Sepsis, MOF and Outcome Prediction in Severely Traumatized Patients 159 Zeljko Lausevic and Mirjana Lausevic Chapter 8 New Biomarkers for Sepsis 171 Lixin Xie VI Contents Chapter 9 The Role of Procalcitonin in the Early Diagnosis of Septic and Non-Septic Complications in the Immediate Postoperative Setting After Orthotopic Liver Transplantation 187 Aristotelis Perrakis, Volker Müller, Werner Hohenberger and Roland S. Croner Chapter 10 Microdialysis Monitoring of Biomarkers for Early Recognition of Intestinal Ischemia 205 Radha Swathe Priya M. and Emma P. Córcoles Chapter 11 Challenges in the Diagnosis of Sepsis of the Neonate 233 Bernhard Resch, Nora Hofer and Wilhelm Müller Chapter 12 Relevance of Procalcitonin for the Diagnosis of Early and Late-Onset Sepsis in Newborns 249 C. Savagner, B. Leboucher, G. Gascoin-Lachambre and C. Gras-Leguen Section 4 Microbiology and Antimicrobial Therapy in Sepsis 259 Chapter 13 Catheter-Related Bloodstream Infections in Critical Care 261 Efraín Riveros Pérez Chapter 14 Beware of Unusual Organisms Masquerading as Skin Contaminants 275 Marilynn R. Fairfax and Hossein Salimnia Chapter 15 Blood Culture Systems: From Patient to Result 287 Andries William Dreyer Chapter 16 Sepsis: Antimicrobial Therapy 311 Renato Finkelstein and Ilana Oren Section 5 Sepsis in Specific Populations 331 Chapter 17 Infections in Leukemia 333 Rekha Chandran, Morgan Hakki and Stephen Spurgeon Section 6 Treatment of Sepsis-Associated Dysfunctions 369 Chapter 18 Continuous Renal Replacement Therapies in Patients with Severe Sepsis and Septic Shock 371 F.J. García-Miguel Chapter 19 Induction Agents for Endotracheal Intubation in Severe Sepsis and Septic Shock 391 Marie Mullen Preface Sepsis, the inflammatory response after an infection, comprises a spectrum of conditions ranging from systemic inflammatory response syndrome to septic shock and multisystem organ failure, the deadly forms of the disease. Sepsis is the major cause of death in non-cardiologic intensive care units around the world. Every year, billions of dollars are consumed in the treatment of patients with this condition as well as in research in order to understand its complex pathophysiology and therefore obtain future therapeutic opportunities. Despite the efforts of the scientists and medical practitioners, the mortality rates are still very high, mainly for underdeveloped and developing countries. In addition, the annual incidence of the disease is increasing, probably due to progressive aging of the population, improvements in critical care support and in immunosuppressive therapies so that individuals with immunosuppression now have increased life expectancy. In this book we intend to provide an update on several fields of this disease. Starting from the history of sepsis and finishing with treatment of sepsis-associated organ dysfunctions, this book offers a wide scope of well-written and complete reviews concerning several pathophysiological and therapeutic aspects of sepsis. We hope that the laborious work of the authors will provide an important forum of discussion on the topic, and increase the awareness of the healthcare team regarding the important aspects of early recognition and treatment of this severe condition. I would also like to acknowledge the assistance of the publishing team and the invitation of the publisher to edit such an interesting and important book. Finally, I would like to thank all of the authors for their excellent contributions. Luciano CP Azevedo State University of São Paulo School of Medicine Federal University of São Paulo Instituto Sirio-Libanes de Ensino e Pesquisa, São Paulo Brazil . SEPSIS – AN ONGOING AND SIGNIFICANT CHALLENGE Edited by Luciano Azevedo Sepsis – An Ongoing and Significant Challenge http://dx.doi.org/10.5772/2958. Sepsis – An Ongoing and Significant Challenge 10 This way we can understand that despite there was not a microorganisms theory, somehow in the ancient