Résumé
Très utilisée pour la classification des patients lors de la réalisation d’études cliniques, la définition usuelle du choc septique est cependant régulièrement critiquée pour son manque de spécificité. Un grand nombre d’affections est en effet susceptible de déclencher, à un stade variable de leur évolution des manifestations cliniques ou biologiques très similaires à celles observées au cours d’un choc infectieux. Ces « chocs pseudo-septiques » peuvent être en rapport avec une inflammation systémique aiguë, un phénomène d’ischémie-reperfusion globale, une réaction d’origine toxique ou anaphylactique, un trouble de la régulation centrale de la température, ou encore des perturbations métaboliques ou endocriniennes. Il est capital de savoir les évoquer au moindre doute, car leur prise en charge est souvent radicalement différente, exigeant la mise en oeuvre immédiate de thérapeutiques spécifiques.
Abstract
Widely used for classification of patients in clinical studies, the usual definition of septic shock is however regularly criticized for its lack of specificity. Many diseases are likely to produce clinical or biological manifestations similar to those observed in septic shock. These “septiclike shocks” may be related to different causes like acute systemic inflammation, global ischemia-reperfusion, toxic reaction, anaphylactic troubles, disorders in central regulation of temperature as well as metabolic or endocrine disturbances. It is of crucial importance to suspect these etiologies, since treatment is often totally different, requiring the immediate implementation of specific therapies.
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Références
Lanceleur A, Cariou A, Dhainaut JF (2009) États de choc: physiopathologie et mécanismes généraux. Traité de Réanimation Médicale. Ed Masson 774–777
Members of American College of chest Physicians/Society of Critical Care Medicine Consensus Conference Commitee (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874
Klein Klouwenberg PM, Ong DS, Bonten MJ, et al (2012) Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Intensive Care Med 38:811–819
Lorne E, Dupont H, Abraham E (2010) Toll-like receptors 2 and 4: initiators of non-septic inflammation in critical care medicine? Intensive Care Med 36:1826–1835
Hochman JS (2003) Cardiogenic shock complicating acute myocardial infarction: expanding the paradigm. Circulation 107:2998–3002
Dzavík V, Cotter G, Reynolds HR, et al (2007) Effect of nitric oxide synthase inhibition on haemodynamics and outcome of patients with persistent cardiogenic shock complicating acute myocardial infarction: a phase II dose-ranging study. Eur Heart J 28:1109–1116
Abraham E (1999) Why immunomodulatory therapies have not worked in sepsis. Intensive Care Med 25:556–566
Solomon LA, Hinshaw LB (1968) Effect of endotoxin on isogravimetric capillary pressure in the forelimb. Am J Physiol 214:443–447
Schutzer KM, Larsson A, Risberg B, Falk A (1993) Lung protein leakage in feline septic shock. Amer Rev Resp Dis 147:1380–1385
Monafo WW (1996) Initial management of burns. N Engl J Med 335:1581–1586
Gueugniaud PY, Vilasco B, Pham E, et al (1996) [Severe burnt patients: hemodynamic state, oxygen transport and consumption, plasma cytokines]. Ann Fr Anesth Reanim 15:27–35
Polk HC (1979) Supportive therapy in burn care. Consensus summary on infection. J Trauma 19(11 Suppl):894–896
Levitt MD, Eckfeldt JH (1993) Diagnosis of acute pancreatitis. In: The pancreas. Biology, pathobiology and disease (pp. 613–635) Go VLW, DiMagno EP, Gardner JD, Lebenthal E, Reber HA, Scheele GA, (eds). New York, Raven Press
Lankisch PG, Schirren CA, Kunze E (1991) Undetected fatal acute pancreatitis: why is the disease so frequently overlooked? Am J Gastroenterol 86:322–326
Godeau B, Mortier E, Roy PM, et al (1997) Short and long-term outcomes about patients with systemic rheumatic diseases in intensive care units: a prognostic study of 181 patients. J Rheumatol 24:1317–1323
Hellmann DB, Petri M, Whiting-O’Keefe Q (1987) Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms. Medicine (Baltimore) 66:341–348
Eberhard OK, Haubitz M, Brunkhorst FM, et al (1997) Usefulness of procalcitonin for differentiation between activity of systemic autoimmune disease (systemic lupus erythematosus/systemic antineutrophil cytoplasmic antibody-associated vasculitis) and invasive bacterial infection. Arthritis Rheum 40:1250–1256
Delevaux I, Andre M, Colombier M, et al (2003) Can procalcitonin measurement help in differentiating between bacterial infection and other kinds of inflammatory processes? Ann Rheum Dis 62:337–340
Levin MA, Lin HM, Castillo JG, et al (2009) Early oncardiopulmonary bypass hypotension and other factors associated with vasoplegic syndrome. Circulation 120:1664–1671
Safar P, Behringer W, Bottiger BW, et al (2002) Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 30:S140–S144
Adrie C, Adib-Conquy M, Laurent I, et al (2002) Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation 106:562–568
Stewart I, Lewis RJ, Eaglesham GK, et al (2010) Emerging tropical diseases in Australia. Part 2. Ciguatera fish poisoning. Ann Trop Med Parasitol 104:557–571
Bourcier S, Mongardon N, Daviaud F, et al (2012) Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock. Am J Emerg Med [E-pub ahead of print]
Dewachter P, Jouan-Huraux V, Franck P, et al (2005) Anaphylactic shock: a form of distributive shock without inhibition of oxygen consumption. Anesthesiology 103:40–49
Fourel D, Ould Ahmed M, Ralec B, et al (2009) Traité de Réanimation Médicale. Ed. Masson pp: 1643–1646
Llach J, Gines P, Arroyo V, et al (1998) Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology 94:482–487
Masset C, Lancellotti P, Nkoghe D (2001) Shoshin beriberi: myth or reality? Rev Med Liege. 56:155–158
Dorin RI, Kearns PJ (1988) High output circulatory failure in acute adrenal insufficiency. Crit Care Med 16:296–297
Jiang YZ, Hutchinson KA, Bartelloni P, et al (2000) Thyroid storm presenting as multiple organ dysfunction syndrome. Chest 118:877–879
Cooper DS (2003) Hyperthyroidism. Lancet 362:459–468
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Cet article correspond à la conférence faite par l’auteur au congrès de la SRLF 2013 dans la session: Des maladies qu’il faut connaître.
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Daviaud, F., Bouglé, A. & Cariou, A. Chocs d’allure septique. Réanimation 22 (Suppl 2), 428–434 (2013). https://doi.org/10.1007/s13546-012-0542-1
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DOI: https://doi.org/10.1007/s13546-012-0542-1