medigraphic.com
Colegio de Medicina Interna de México.

2025, Número 05

<< Anterior

Med Int Mex 2025; 41 (05)


Síndrome postsepsis: estrategias para prevenirlo. Revisión descriptiva

Segura LV, González MKI, Morales RJD, Velázquez CA, Peña PCA, Cruz LJ

Idioma: Español
Referencias bibliográficas: 37
Paginas: 291-301
Archivo PDF: 236.97 Kb.


RESUMEN

Antecedentes: El síndrome postsepsis es un padecimiento emergente que en las últimas dos décadas ha suscitado un gran interés entre clínicos e investigadores. Se caracteriza por un riesgo significativamente mayor de muerte y una mala calidad de vida asociada con una serie de efectos a largo plazo que persisten luego de la sepsis.
Metodología: Revisión descriptiva (narrativa) del síndrome postsepsis. Búsqueda en las bases de datos de PubMed y Google Scholar de artículos publicados, en idima inglés, entre los años 2000 al 2020 con los términos MeSH: Post-sepsis syndrome; Sepsis; Mortality, que contemplaran datos epidemiológicos y propuestas para prevención del síndrome.
Resultados: Se encontraron 2800 artículos de los que se seleccionaron 35 para la revisión, más otros dos para información epidemiológica complementaria.
Conclusión: Las tasas de mortalidad después de supervivir al episodio inicial de sepsis siguen siendo altas; dependiendo de su gravedad. La tasa de mortalidad a un año varía de 7 hasta 43% y la mortalidad a los 5 años puede alcanzar 80% que, con más frecuencia es secundaria al síndrome postsepsis porque aumenta el riesgo de reingreso hospitalario por infecciones y la incidencia de disfunción cognitiva, de salud mental, lesión renal y enfermedades cardiovasculares.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, etal. The Third International Consensus Definitions for Sepsisand Septic Shock (Sepsis-3). JAMA 2016; 315 (8): 801-10.https://doi.org/10.1001/jama.2016.0287

  2. Neira-Sanchez ER, Málaga G. Sepsis-3 y las nuevas definiciones,¿es tiempo de abandonar SIRS? Acta Med Peru2016 (3): 217-22.

  3. Bone RC, Balk RA, Cerra FB, Dellinger RP, et al. Definitionsfor sepsis and organ failure and guidelines for the use ofinnovative therapies in sepsis. The ACCP/SCCM ConsensusConference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101(6): 1644-55. https://doi.org/10.1378/chest.101.6.1644

  4. PAHO. Sepsis: Information General; Pan American HealthOrganization-World Health Organization, 2022.

  5. Rizo-Amézquita JN, Alonso-Molina A. La sepsis como causasde egreso hospitalario en México; una revisión retrospectiva2008-2015. Boletín CONAMED-OPS 2018; 3 (17).

  6. Mostel Z, Perl A, Marck M, et al. Post-sepsis syndrome -anevolving entity that afflicts survivors of sepsis. Mol Med2020; 26 (6).

  7. Prescott HC, Angus DC. Enhancing recovery fromsepsis. JAMA 2018; 319 (1). https://doi.org/10.1001/jama.2017.17687

  8. Hajj J, Blaine N, Salavaci J, Jacoby D. The “Centrality ofSepsis”: A Review on Incidence, Mortality, and Cost of Care.Healthcare (Basel) 2018; 6 (3): 90. https://doi.org/10.3390/healthcare6030090

  9. Ferreras JM, Judez D, Tirado G, Aspiroz C. Implementaciónde un sistema de alarmas automático para la detecciónprecoz de los pacientes con sepsis grave. EnfermedadesInfecciosas y Microbiología Clínica 2015; 33 (8) 508-515.https://doi.org/10.1016/j.eimc.2015.11.014

  10. Mostel Z, Perl A, Marck M, et al. Post-sepsis syndrome -anevolving entity that afflicts survivors of sepsis. Mol Med2020; 26 (6).

  11. Schmidt K, Worrack S, Von Korff M, Davydow D, et al. Effectof a Primary Care Management Intervention on MentalHealth-Related Quality of Life Among Survivors of Sepsis:A Randomized Clinical Trial. JAMA 2016; 315 (24): 2703-11.https://doi.org/10.1001/jama.2016.7207

  12. Huang CY, Daniels R, Lembo A, Hartog CH, et al. Life aftersepsis: an international survey of survivors to understandthe post-sepsis syndromeInt J Qual Health Care 2019; 31(3): 191-98. https://doi.org/10.1093/intqhc/mzy137

  13. Zachary M, Perl A, Marck M, Mehdi SF, et al. Post-sepsis syndrome– an evolving entity that afflicts survivors of sepsis.Molecular Medicine 2020; 26: 6. https://doi.org/10.1186/s10020-019-0132-z

  14. van der Slikke EC, An AY, Hancock REW, Bouma HR. Exploringthe pathophysiology of post-sepsis syndrome to identifytherapeutic opportunities. EBioMedicine 2020; 61: 103044.https://doi.org/10.1016/j.ebiom.2020.103044

  15. Van der Slikke, E. C., An, A. Y., Hancock, R. E. W., & Bouma,H. R. (2020). Exploring the pathophysiology of post-sepsissyndrome to identify therapeutic opportunities. Ebio-Medicine 2020; 61: 103044. https://doi.org/10.1016/j.ebiom.2020.10304

  16. Li Ying, Ji Muhuo, Yang Jianjun, Current Understanding ofLong-Term Cognitive Impairment After Sepsis. Front Immunol2022; 13. https://doi.org/10.3389/fimmu.2022.855006

  17. Huang C, Daniels R, Lembo A, et al. Sepsis survivors’satisfaction with support services during and after theirhospitalization. Crit Care Med 2016; 44 (12): 425. https://doi.org/10.1097/01.ccm .0000510071.45969.89

  18. Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitiveimpairment and functional disability among survivorsof severe sepsis. JAMA 2010; 304 (16): 1787-94. https://doi.org/10.1001/jama.2010.1553

  19. Arens C, Bajwa SA, Koch C, et al. Sepsis-induced long-termimmune paralysis results of a descriptive, explorativestudy. Crit Care 2016;20. https://doi.org/10.1186/ s13054-016-1233-5

  20. Cross D, Drury R, Hill J, Pollard AJ. Epigenetics in sepsis:understanding its role in endothelial dysfunction, immunosuppression,and potential therapeutics. Front Immunol2019;10. https://doi.org/10.3389/fimmu.2019.01363

  21. Francois B, Jeannet R, Daix T, et al. Interleukin-7 restoreslymphocytes in septic shock: the IRIS-7 randomizedclinical trial. JCI Insight 2018;3. https://doi.org/10.1172/jci. insight.98960

  22. Rothenhausler HB, Ehrentraut S, Stoll C, Schelling G,Kapfhammer HP. The relationship between cognitiveperformance and employment and health status inlong-term survivors of the acute respiratory distresssyndrome: results of an exploratory study. Gen HospPsychiatry 2001; 23: 90-6. https://doi.org/10.1016/s0163- 8343(01)00123-2

  23. Bruck E, Schandl A, Bottai M, Sackey P. The impact ofsepsis, delirium, and psychological distress on self-ratedcognitive function in ICU survivors—a prospective cohortstudy. J Intensive Care 2018; 6. https://doi.org/10.1186/s40560-017-0272-6

  24. Sonneville R, de Montmollin E, Poujade J, et al. Potentiallymodifiable factors contributing to sepsis-associatedencephalopathy. Intensive Care Med 2017; 43: 1075-84.https://doi.org/10.1007/s00134-017-4807-z

  25. Manfredini A, Constantino L, Pinto MC, et al. Mitochondrialdysfunction is associated with long-term cognitiveimpairment in an animal sepsis model. Clin Sci Lond Engl2019; 133: 1993-2004 1979. https://doi.org/10.1042/CS20190351

  26. Chavan SS, Huerta PT, Robbiati S, et al. HMGB1 mediatescognitive impairment in sepsis survivors. Mol Med 2012;18: 930-7. https://doi.org/10.2119/molmed.2012.00195

  27. Polito A, Eischwald F, Maho A-LL, et al. Pattern of braininjury in the acute setting of human septic shock. Crit Care2013; 17: R204. https://doi.org/10.1186/cc12899

  28. Parker AM, Sricharoenchai T, Raparla S, Schneck KW,Bienvenu OJ, Needham DM. Posttraumatic stress disorderin critical illness survivors: a metaanalysis. CritCare Med 2015; 43: 1121-9. https://doi.org/10.1097/CCM.0000000000000882

  29. Rabiee A, Nikayin S, Hashem MD, et al. Depressive symptomsafter critical illness: a systematic review and metaanalysis.Crit Care Med 2016; 44: 1744-53. https://doi.org/10.1097/CCM.0000000000001811

  30. Kress JP, Gehlbach B, Lacy M, Pliskin N, et al. The long-termpsychological effects of daily sedative interruption oncritically ill patients. Am J Respir Crit Care Med 2003; 168:1457-61. https://doi.org/10.1164/rccm.200303-455OC

  31. Peris A, Bonizzoli M, Iozzelli D, et al. Early intra-intensivecare unit psychological intervention promotes recoveryfrom post-traumatic stress disorders, anxiety and depressionsymptoms in critically ill patients. Crit Care 2011; 15:R41. https://doi.org/10.1186/cc10003

  32. Schmidt KF, Schwarzkopf D, Baldwin L-M, et al. Long-termcourses of sepsis survivors: effects of a primary care managementintervention. Am J Med 2020; 133:381–5 e5. doi:10.1016/j.amjmed.2019.08.033.

  33. Ou SM, Chu H, Chao PW, et al. Long-term mortality andmajor adverse cardiovascular events in sepsis survivors.a nationwide population-based study. Am J Respir CritCare Med 2016; 194: 209-17. https://doi.org/10.1164/rccm.201510-2023OC

  34. Prescott HC, Chang VW, O’Brien JM, Langa KM, et al.Obesity and 1-year outcomes in older Americans withsevere sepsis. Crit Care Med 2014; 42: 1766-74. https://doi.org/10.1097/CCM.0000000000000336.

  35. American Diabetes Association. 10. Cardiovascular diseaseand risk management: standards of medical care indiabetes-2020. Diabetes Care 2020; 43: S111-34. https://doi.org/10.2337/dc20-S010

  36. Chao P, Shih CJ, Lee YJ, et al. Association of postdischargerehabilitation with mortality in intensive care unit survivorsof sepsis. Am J Respir Crit Care Med 2014; 190: 1003-11.https://doi.org/10.1164/rccm.201406-1170OC

  37. Van der Slikke EC, Beumeler LFE, Holmqvist M, Linder A,et al. Understanding Post-Sepsis Syndrome: How Can CliniciansHelp? Infect Drug Resist 2023; 16: 6493-511. https://doi.org/10.2147/IDR.S390947




2020     |     www.medigraphic.com