SEPSIS DEFINITIONS — WAYS TO CONSENSUS OF CLINICIANS AND MORPHOLOGISTS
Keywords:
diagnosis of sepsis, postmortem examination (autopsy)Abstract
This article is devoted to the old challenge between clinicians and morphologists — to reach common understanding in the pathogenesis of the sepsis. The latest epidemiological researches have shown that sepsis is the main reason of mortality in the general Intensive Care Unit. Today one of the unresolved issues of a problem of sepsis is a question of verification of the diagnosis of sepsis at postmortem examination, especially due to new (1991) criteria of definitions, that include: sepsis, severe sepsis and septic shock, but commonly used “septicemia” and “septicopyemia” are excluded. According to our data, in more than a half of percent of cases of the sepsis diagnosed on the basis of the АССР/SCCM criteria, the diagnosis wasn’t established at autopsy, because typically, pathomorphologies signs of sepsis, such as septicopyemia, large spleen are absent. Allegedly, this indicator of the average across many hospitals of the Russian Federation is much higher. The diagnosis of the sepsis which hasn’t been established at postmortem examination, will not be recorded in statistical documentation. In article, the reasons of the stated problem are considered and ways its solutions are proposed. It does impossible maintaining the accounting of septic patients, development and introduction of effective methods of treatment and sepsis prevention.
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