Sepsis Management, Controversies, and Advancement in Nanotechnology: A Systematic Review.

Rabia Choudhary

doi:10.7759/cureus.22112

Abstract

Sepsis is a potentially dangerous infection that requires prompt identification and treatment. Emergency medicine physicians must grasp the clinical signs and laboratory results of direct and indirect organ failure, the source of infection management, and the criteria for treating sepsis and septic shock. The pathogenesis of sepsis is connected to inflammation and an excess of reactive oxygen and nitrogen species, which activate the pathogen-associated molecular pattern (PAMP)-pattern recognition receptor (PRR) and damage-associated molecular pattern (DAMP)-PRR signaling pathways. The development of rapid, sensitive, and precise techniques for sepsis diagnosis might be aided by nanotechnology, a part of nanomedicine. Nanoparticles (NPs) such as magnetic NPs, gold NPs, fluorescent (silica and quantum dots), and lipid-based NPs have all been discussed to contribute to the detection of sepsis-related microbial infections. Because of the intrinsic and unique features of these nano-sized systems, researchers are evaluating nanotechnology-based alternatives for sepsis control. Recent advances in nanotechnology-based technologies for sepsis detection and management are discussed in this study.Databases (PubMed, Medline, PMC, Google Scholar) were used to source various studies that were carried out on sepsis in terms of assessment, types, diagnosis, and treatment controversies, with more attention being given with a focus on the most recent data, principles, and management guidelines. Priority was also given to studies published within the last 11 years, using keywords such as "sepsis guidelines," "sepsis clinical," "septic risk factors," "sepsis and nano technology," "nano particles," "sepsis controversies," and "nano diagnostic" in the search. After a filtration process, the eight most relevant studies were selected to be included in this review. The filtration process included the use of both inclusion and exclusion criteria. The excluded studies were pediatric populations, obstetrical populations, and nanotechnology advancements dealing with other fields not relating to sepsis. The selected studies were also undertaken through a quality appraisal process using corresponding assessment tools. The selected articles were all highly informative about sepsis and the processes of diagnosis and treatment that are currently in use as well as those that are still being developed or implemented. Furthermore, we look at how nanomedicine in the application of nanomaterials can be employed to efficiently manage sepsis.

Highlights

BackgroundSeptic shock is a major healthcare issue in many countries, with a high mortality rate
A total of 6,000 papers were found during the initial search for publications relevant to updates and controversies in early sepsis management, including nanosensors used in medication resistance for sepsis, which were narrowed down to 195 articles relating to early sepsis and septic shock guidelines published between 2010 and 2021
The articles chosen for inclusion in the review were further screened to ensure that they were on adult people, excluding the obstetrics and pediatric populations, and that they were published in English

Summary

Introduction

Septic shock is a major healthcare issue in many countries, with a high mortality rate. The mortality rate associated with septic shock has been estimated to be between 28% and 50 % in developed countries and higher (45 % to 74.6 %) in low-income countries. The primary cause of this has been identified as poor clinical diagnosis and management protocol for sepsis and its consequences, such as septic shock and multiorgan dysfunction, which have been pronounced during the surgical and anesthesia period [1]. Sepsis is a life-threatening condition that arises when the immune system's response to infection is altered. It is usually brought on by a systemic illness. Immune abnormalities generated by pathogenic microorganisms or tissue damage cause some aspects of the illness, culminating in organ failure and death. Multi-organ failure is a combination of cardiovascular, cellular, coagulation, and endothelial dysfunction, and is sometimes referred to as "the four horsemen of the septic apocalypse" [1,2]

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