Table Of ContentK. Reinhart K. Eyrich
(Editors)
An Interdisciplinary Challenge
With 10 I Figures and 73 Tables
Springer-Verlag
Berlin Heidelberg GmbH
Priv.-Doz. Dr. K. Reinhart
Prof. Dr. med. K. Eyrich
Freie Universitiit Berlin, Universitiitsklinikum Steglitz
Klinik fUr Aniisthesiologie und operative Intensivmedizin
Hindenburgdamm 30, 1000 Berlin 45JFRG
Library of Congress Cataloging-in-Publication Data.
Sepsis: an interdisciplinary challenge / K. Reinhart, K. Eyrich (eds.). p. cm.
Papers amended from discussions at the 2nd International Steglitz Symposium
held in Berlin in Oct. 1987.
ISBN 978-3-642-83085-3 ISBN 978-3-642-83083-9 (eBook)
DOI 10.1007/978-3-642-83083-9
1. Septicemia-Congresses. 2. Septic shock-Congresses. I. Reinhart, K. II.
Eyrich, K. III. International Steglitz Symposium (2nd: 1987 : Berlin, Germany)
[DNLM: 1. Infection-congresses. 2. Shock, Septic-congresses. WC 195 S479
1987] RC182.S4S45 1989 616.9'44-dc19 DNLM/DLC for Library of
Congress 88-36894 CIP
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Preface
A high proportion of the morbidity and mortality of hospital patients is due to sepsis
and septic shock. Although our knowledge of this complex disease has been consider
ably broadened in recent years, it is still incomplete. On the basis of improved
pathophysiological knowledge, new therapeutic approaches have been developed, but
their value remains to be demonstrated in clinical practice. Many clinicians who are
routinely responsible for treating sepsis or septic shock are often unsure of the dis
tinction between confirmed knowledge and mere speculation about the condition.
It is the aim of this monograph to offer basic information on the etiology,
pathophysiology, prevention, and therapy of sepsis and septic shock to both the
clinician and the scientist. This book has resulted from the 2nd International Steglitz
Symposium held in Berlin in October 1987. The internationally recognized authors
have amended their manuscripts to incorporate the ideas raised during the discussions
of their papers at the meeting. Each chapter is a summary of the current understand
ing within a specific area. We believe that this monograph presents an extensive
overview that may help the clinician to better understand and treat sepsis and septic
shock. We also hope that this work will give some direction for future research.
Berlin, January 1989 K.Reinhart
K.Eyrich
List of Contributors
Armistead, Jr., C. w.
Departement de Soins-Intensif Cmr., Erasme Hopital, Universite Libre
de Bruxelles, Rue de Lennik 808, 1070 Bruxelles, Belgium
Baue, A. E.
Department of Surgery, St. Louis University Medical Center, School of Medicine,
3556 Caroline St., St. Louis, MO 63104, USA
Baumgartner, J. D.
Department of Infectious Disease, Universitaire Vaudois, 1011 Lausanne,
Switzerland
Beger, H. O.
Abteilung fUr Allgemeine Chirurgie, Klinikum der Universitiit Ulm,
Steinh6ve1str. 9, 7900 Ulm, FRO
Berger,D.
Abteilung fUr Allgemeine Chirurgie, Klinikum der Universitiit Ulm,
Steinh6ve1str. 9, 7900 Ulm, FRO
Bersten, A. D.
Critical Care/Trauma Unit, Victoria Hospital, 375 South Street, London, Ontario
N6A 405, Canada
v. BUlow, J.
Institut fUr Klinische Chemie, Klinikum Steglitz der Freien Universitiit Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRO
Cain, S. M.
Department of Physiology and Biophysics, University of Alabama, Birmingham,
AL 35294, USA
Calandra, T.
Department of Infectious Disease, Universitaire Vaudois, 1011 Lausanne,
Switzerland
VIII List of Contributors
Cerra, F. B.
Department of Surgery, Medical School, University of Minnesota,
516 Delaware St. SE, Minneapolis, MN 55455, USA
Chernow, B.
Massachusetts General Hospital, Fruit Street, Boston, MA 02114, USA
Daeschlein, G.
Institut fUr Medizinische Mikrobiologie der Freien UniversWit Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Daschner, F.
Klinikum der Albert-Ludwigs-Universitiit, Hugstetter Str. 55, 7800 Freiburg, FRG
Dennhardt, R.
Anaesthesieabteilung, Krankenhaus Nordwest der Stiftung zum Heiligen Geist,
Steinbacher Hohl 2-26, 6000 Frankfurt am Main, FRG
Dietrich, A.
Institut fUr Theoretische Chirurgie, Zentrum fUr Operative Medizin I,
Klinikum der Philippsuniversitiit, BaldingerstraBe, 3550 Marburg, FRG
Fangmann, B.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitiit Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Glauser, M. P.
Department of Infectious Disease, Universitaire Vaudois, 1011 Lausanne,
Switzerland
Goecke, J.
Klinik fUr Anaesthesiologie und Operative Intensivmedizin, Klinikum Steglitz
der Freien Universitiit Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
Gramm, H.-J.
Klinik fUr Anaesthesiologie und Operative Intensivmedizin, Klinikum Steglitz
der Freien Universitiit Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
Griffiss, M. J.
Department of Medicine, School of Medicine, VA Medical Center,
113Aj4150 Clement Street, San Francisco, CA 94121, USA
Hahn, H.
Institut fUr Medizinische Mikrobiologie der Freien Universitiit Berlin,
Hindenburgdamm 27, 1000 Berlin 45, FRG
List of Contributors IX
Haring, R.
Abteilung fUr Allgemein-, Thorax- und Gefafichirurgie, Klinikum Steglitz
der Freien Universitat Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
Hammersen, F.
Abteilung fUr Experimentelle Chirurgie, Chirurgisches Zentrum, Ruprecht-Karls
Universitat, 1m Neuenheimer Feld 347, 6900 Heidelberg, FRG
Higgins, T. L.
Department of Cardiothoracic Anaesthesia, The Clinic Foundation,
9500 Euclid Avenue, Cleveland, OH 44106, USA
Hirner, A.
Abteilung fur Allgemein-, Thorax- und Gefafichirurgie, Klinikum Steglitz
der Freien Universitat Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
Holaday, 1. W.
Department of Medical Neurosciences, Walter Reed Army Institute of Research,
Washington, DC 20307, USA
Hund, M.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Kappstein, I.
Klinikum der Albert-Ludwigs-Universitat, Hugstetter Str. 55, 7800 Freiburg, FRG
Kemmerich, B.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Kreimeier, U.
Abteilung fUr Experimentelle Chirurgie, Chirurgisches Zentrum, Ruprecht-Karls
Universitat, 1m Neuenheimer Feld 347, 6900 Heidelberg, FRG
Lode, H.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
L6hr, A.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Long, W. M.
Internal Medicine and Intensive Care, University of Miami, Veterans Station
Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
x
List of Contributors
Lorenz, W.
Institut fUr Theoretische Chirurgie, Zentrum fUr Operative Medizin I,
Klinikum der Philippsuniversitat, BaldingerstraBe, 3550 Marburg, FRG
Meakins, J. L.
Department of Surgery, McGill University, Montreal, Quebec PQ-H3A IAI,
Canada
Meinhold, H.
Abteilung fiir Nuklearmedizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Messmer, K.
Abteilung fUr Experimentelle Chirurgie, Chirurgisches Zentrum, Ruprecht-Karls
Universitat, 1m Neuenheimer Feld 347, 6900 Heidelberg, FRG
Miiller, F.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRG
Neugebauer, E.
Institut fUr Theoretische Chirurgie, Zentrum fUr Operative Medizin I,
Klinikum der Philippsuniversitat, BaldingerstraBe, 3550 Marburg, FRG
Oettinger, W.
Abteilung fUr Allgemeine Chirurgie, Klinikum der Universitat Ulm,
Steinh6velstr. 9, 7900 UIm, FRG
Parrillo, J. E.
Critical Care Medicine Department, National Institutes of Health, Bethesda,
MD 20892, USA
Parker, M. M.
Critical' Care Medicine Department, National Institutes of Health, Bethesda,
MD 20892, USA
Peter, F.
Abteilung fiir A1lgemein-, Thorax- und GefaBchirurgie, Klinikum Steglitz
der Freien Universitat Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
Raper, R. F.
Critical Care/Trauma Unit, Victoria Hospital, 375 South Street, London, Ontario
N6A 4G5, Canada
Reinhart, K.
Klinik fUr Anasthesiologie und operative Intensivmedizin, Klinikum Steglitz
der Freien Universitat Berlin, Hindenburgdamm 30, 1000 Berlin 45, FRG
List of Contributors XI
Schein, R. M. H.
Internal Medicine and Intensive Care, University of Miami, Veterans Station
Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
Schirren, J.
Institut fUr Theoretische Chirurgie, Zentrum fUr Operative Medizin I, Klinikum
der Philippsuniversitat, BaldingerstraBe, 3550 Marburg, FRO
Schuster, H.-P.
Medizinische Klinik I, Stadtisches Krankenhaus, Weinberg 1, 3200 Hildesheim,
FRO
Sheagren, J. N.
Department of Internal Medicine, Medical School, University of Michigan,
M7300 Medical Science Building, Ann Arbor, MI 48109, USA
Sibbald, W. J.
Critical Care/Trauma Unit, Victoria Hospital, 375 South Street, London, Ontario
N6A 405, Canada
Sprung, C. L.
Internal Medicine and Intensive Care, University of Miami, Veterans Station
Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA
Storm, W.
Sauglings- und Kinderklinik, st. Vincenz-Krankenhaus, Am Busdorf 2-4a,
4790 Paderborn, FRO
Suter, P. M.
Departement d'A nesthesiologie, Division de Soins - Intensifs Chir.,
Hopital Cantonal Universitaire, 1211 Oeneve 4, Switzerland
Vincent J. L.
Departement de Soins - Intensif Chir., Erasme Hopital, Universite Libre
de Bruxelles, Rue de Lennik 808, 1070 Bruxelles, Belgium
Voigt, K.
Institut fUr normale und pathologische Physiologie der Philippsuniversitat,
BoldingerstraBe, 3550 Marburg, FRO
Wagner, J.
Abteilung fUr Innere Medizin, Klinikum Steglitz der Freien Universitat Berlin,
Hindenburgdamm 30, 1000 Berlin 45, FRO
Watters, J.
Department of Surgery, Ottawa Civic Hospital, 1053 Carling Avenue, Ottawa,
Ontario KIY 4E9, Canada
XII List of Contributors
Wilmore, D. W.
Department of Surgery, Ottawa Civic Hospital, 1053 Carling Avenue, Ottawa,
Ontario KIY 4E9, Canada
Wilson, R. F.
Department of Surgery, School of Medicine, Wayne State University,
4201 St. Antoine, Detroit, MI 48201, USA
Wittmann, H. G.
Max-Planck-Institut fUr Molekulare Genetik, Ihnestr. 73, 1000 Berlin 33, FRG
Zimmerman, J. J.
Department of Pediatrics, School of Medicine, University of Wisconsin,
600 Highland Avenue, Madison, WI 53792, USA
