DETERMINANT FACTORS FOR THE DEVELOPMENT OF SEPSIS IN THE INTENSIVE CARE UNIT

Abstract

Sepsis is a leading cause of morbidity and mortality among critically ill patients and poses a significant challenge for intensive care services. It is characterized by life-threatening organ dysfunction resulting from a dysregulated host response to infection. The development of sepsis in patients admitted to the Intensive Care Unit (ICU) stems from a complex interplay of factors, including host characteristics, disease severity, comorbidities, immunosuppression, exposure to invasive procedures, healthcare-associated infections, prior antimicrobial use, colonization by multidrug-resistant microorganisms, and length of stay. The critical illness itself promotes alterations in the epithelial barrier, immune function, microbiota, tissue perfusion, and organ integrity, thereby increasing susceptibility to infection and progression to organ dysfunction. Key care-related factors include mechanical ventilation, intravascular catheters, urinary catheterization, surgical procedures, parenteral nutrition, prolonged antimicrobial exposure, and extended ICU stays. Early identification of these factors enables the implementation of strategies for prevention, epidemiological surveillance, infection control, rational antimicrobial use, and timely recognition of clinical deterioration. This article presents a narrative review of the primary determinants of sepsis development in adult ICU patients, highlighting aspects related to the host, the infection, the hospital environment, and therapeutic interventions.