MARKERS OF MICROCIRCULATORY INSUFFICIENCY AND IMMUNE DYSFUNCTION IN THE PROGNOSIS OF SEPSIS IN DIABETIC FOOT SYNDROME

Boymurodov Khasan Abdurakhmonovich

Authors

Boymurodov Khasan Abdurakhmonovich Author

Abstract

Diabetic foot syndrome (DFS) is one of the most severe and socially significant complications of diabetes mellitus, characterized by a high frequency of infectious processes, prolonged wound healing, risk of amputation, and mortality. According to various studies, infectious complications in DFS occur in 40–60% of patients and are often complicated by systemic inflammatory response and sepsis, which significantly worsens prognosis and increases hospital mortality rates.

References

1. Armstrong D.G., Boulton A.J.M., Bus S.A. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367–2375.

2. Lipsky B.A., Senneville É., Abbas Z.G. et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes. Diabetes Metab Res Rev. 2020;36(S1):e3280.

3. Edmonds M., Manu C., Vas P. The current burden of diabetic foot disease. J Clin Orthop Trauma. 2021;17:88–93.

4. Singer M., Deutschman C.S., Seymour C.W. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–810.

5. Hotchkiss R.S., Moldawer L.L. Dysregulated host response to infection in sepsis. Nat Rev Immunol. 2014;14(3):193–206.

6. Ince C., Mayeux P.R., Nguyen T. et al. The endothelium in sepsis. Shock. 2016;45(3):259–270.

7. Schaper N.C., van Netten J.J., Apelqvist J. et al. IWGDF Guidelines on the prevention and management of diabetic foot disease. Diabetes Metab Res Rev. 2020;36(S1):e3269.

8. Frykberg R.G., Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care. 2015;4(9):560–582.

9. Game F., Jeffcoate W. The role of neuropathy and ischemia in diabetic foot infection. Diabetes Metab Res Rev. 2016;32(S1):S84–S91.

10. Vincent J.L., Dubois M.J., Schmit X. et al. The value of blood lactate kinetics in critically ill patients. Crit Care. 2008;12(6):R163.

11. Pierrakos C., Vincent J.L. Sepsis biomarkers: a review. Crit Care. 2010;14(1):R15.

12. Delamaire M., Maugendre D., Moreno M. et al. Impaired leukocyte functions in diabetic patients. Diabet Med. 1997;14(1):29–34.

13. Falanga V. Wound healing and its impairment in the diabetic foot. Lancet. 2005;366(9498):1736–1743.

14. Kumar A., Roberts D., Wood K.E. et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in septic shock. Crit Care Med. 2006;34(6):1589–1596.

15. Blatun L.A., Paskhalova Yu.S. Infectious complications of diabetic foot syndrome. Surgery. 2019;7:45–52.