Sepsis and cirrhosis are both characterised by a hyperdynamic state associated with a low systemic vascular resistance, and the release of many mediators. The haemodynamic characteristics are so similar that sepsis is difficult to recognise in cirrhotic patients. Nevertheless, the occurrence of sepsis in cirrhotic patients is associated with high mortality rates. The resemblance of the two conditions may be in part related to the common translocation of bacterial products in cirrhosis. This article reviews the similarities and differences between sepsis and cirrhosis and defines the basis for the treatment of severe sepsis in cirrhotic patients.
E Colombaroli, Katia Donadello, N Al Jaridi, Thierry Gustot, Sabino Scolletta, Leonardo Gottin, Jacques Créteur, Jean Louis Vincent, Fabio Taccone, Daniel De Backer
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