Diagnostic paradoxes of sepsis

Abstract

Sepsis is currently one of the most important problems of medicine, and the treatment of this category of patients presents great difficulties and is characterized by high mortality. Acute Pneumonia (AP) has been the leading cause of septic conditions for many years, the proportion of which has recently begun to exceed half of all cases. The modern concept of AP considers the causative agent of the disease as the main cause of its occurrence and development, but for many years the search for reliable differential diagnostic criteria depending on the etiology has not been found. The peculiarities of the localization of AP, unlike other inflammatory diseases, force us to pay attention to the fundamental differences in the parameters of blood flow in the two circulatory circles. The inevitability of the onset of the inflammatory process with a vascular reaction forces us to understand the mechanisms of AP development on the basis of already studied, confirmed, and classical materials of medical science. New ideas about the pathogenesis of the disease make it possible to understand its leading importance in the observed pattern of AP and to recognize the obvious over diagnosis of sepsis in this category of patients. Understanding the need for such a step can significantly reduce the number of patients with sepsis, and a pathogenetic approach to medical care will really improve treatment outcomes.