Intra-abdominal infection in the light of the recent international guidelines, and its role in the development of septic encephalopathy

L.O. Maltseva, M.F. Mosentsev, V.M. Lisnycha

Abstract


The purpose of these recommendations is to present an evidence-based international consensus position on the management of intra-abdominal infections, and the influence of intra-abdominal infections on the development of septic encephalopathy. Complicated intra-abdominal infection is an important cause of morbidity and mortality. In the presentation of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be represented by an increase in the Sequential Organ Failure Assessment (SOFA) score of 2 points or more, and impaired mental status is one of frequent sign in quick SOFA score. Early detection of patients with abdominal sepsis is an essential step for an effective treatment in order to improve outcome. Microvascular dysfunction, global tissue damage can lead to septic encephalopathy that was associated with poor prognosis. The key factors in the effective treatment of intra-abdominal infections are a prompt diagnosis, adequate resuscitation, early initiation of appropriate antibiotic therapy, early infection source control and reassessment of the clinical response to the management. Grading strength of re­commendation and quality of evidence in clinical guidelines are presented in comparison with the Grading of Recommendations Assessment, Development and Evaluation methodology.

Keywords


review; intra-abdominal infection; sepsis; septic encephalopathy

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DOI: https://doi.org/10.22141/2224-0586.1.88.2018.124967

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