Sepsis in cancer patients admitted in the ICU: epidemiology, pathophysiology, and biomarkers

Abstract

Sepsis is one of the main causes of hospitalization in intensive care centers with high rates of morbidity and mortality. Its association with neoplasias has become a highlight due to increased use of propedeutics and interventional therapy that promotes breaking the barriers that protect the host and reduce physical bodily defenses favoring the host invasion by microorganisms. Little is known about these interrelationships. This review off of the MedLine database in interface with Pubmed aims to describe the epidemiology, pathophysiology, and biomarkers in oncology patients admitted in intensive care due to severe sepsis or septic shock. In septic patients without neoplasia, the association of different biomarkers has been the object of study of diagnosis, determination of severity, and outcome. In cancer patients, the biomarkers were primarily used in specific patient subgroups, such as neutropenics, with hematological disease, in order to determine infection. Further studies are required to know how the subgroups of patients with neoplasias behave and to understand and address more appropriately sepsis and septic shock.

Sepsis-associated Pathways Segregate Cancer Groups

“…Muscle wasting, observed in patients with cancer, severe injury and sepsis, is associated with increased expression of several genes, particularly transcription factors and nuclear cofactors, regulating different proteolytic pathways [11]. CD11b/CD18 expression in monocytes has been proposed as a biomarker of infection in cancer patients [12]. These studies focused on the gene as the functional unit of analysis.…”