Prevention of sepsis in patients with impaired splenic function

Authors

DOI:

https://doi.org/10.33448/rsd-v12i10.43583

Keywords:

Asplenia; Hyposplenia; Sepsis; Prophylaxis.

Abstract

Asplenia refers to the complete loss of spleen function, while hyposplenism refers to the partial loss of splenic function, which may be of primary or secondary origin. The spleen is a secondary lymphoid organ, however, it is also connected with blood circulation. This organ houses a variety of cells, such as T and B lymphocytes, macrophages, dendritic cells, cytokines and antibodies essential for the development of immune responses. In this context, sepsis represents a risk for this group of patients and should be avoided with prophylactic measures, with the majority of infections being caused by encapsulated bacteria. To this end, a literature review was prepared with the main evidence on the prevention of sepsis in patients with asplenia/hyposplenia, using 17 materials from the SciELO, PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews (CDSR) databases, EBSCOhost, Virtual Health Library (VHL) and UpToDate. Prevention of sepsis in patients with asplenia or hyposplenia has been shown to involve a combination of vaccination, antibiotic prophylaxis, patient education, and appropriate medical monitoring. It is essential that patients follow medical advice and are aware of the risks and preventive measures necessary to protect their health. Due to the lifelong risk associated with infection in these patients, efforts are focused on improving the quality of care provided to children and adults with restricted splenic function, in addition to ongoing research aimed at alternatives for preventing and treating this condition.

References

Brasil. (2019). Ministry of Health. Health Surveillance Secretariat. Department of Immunization and Communicable Diseases. Manual of Reference Centers for Special Immunobiologicals [electronic resource] / Ministry of Health, Health Surveillance Secretariat, Department of Immunization and Communicable Diseases, General Coordination of the National Immunization Program. (5th ed.), Brasília: Ministry of Health.

Chong, J. et al. (2017). Overwhelming post-splenectomy sepsis in patients with asplenia and hyposplenia: a retrospective cohort study. Epidemiol Infect., 145 (22), 397–400.

Davies, J. M., et al. (2011). Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato. Br J Haematol., 155 (7), 308–317.

Dendle, C. et al. (2012). Sequelae of splenectomy: an analysis of infectious outcomes among adults in Victoria. Med JAust., 19 (6), 582–586.

Di Sabatino, A., Carsetti, R. & Corazza, G. R. (2011). Post-Splenectomy And Hyposplenic States. Lancet, 37 (8), 86-97.

Duarte, L. et al. (2014). Prevention of Post-Splenectomy Sepsis: creation of a vaccination and patient education guideline. Portuguese Journal of Surgery, 31 (8), p. 9-18.

Edgren, G. et al. (2014). Splenectomy and the risk of sepsis: a population-based cohort study. Ann Surg., 260 (6), 1081–1087.

Hernandez, M. C et al. (2019). Vaccination and Splenectomy in Olmsted County. Surgery, 166 (4), 556-563.

Kanhutu, K. et al. (2017). Spleen Australia guidelines for the prevention of sepsis in patients with asplenia and hyposplenism in Australia and New Zealand. Medical Intern J., 47 (8), 848-855.

Lee, G. M (2020). Preventing infections in children and adults with asplenia. Hematology Am Soc Hematol Educ Program., 20 (11), 328-335, 2020.

Luu, S. et al. (2019). Post-splenectomy sepsis: preventative strategies, challenges, and solutions. Infection and drug resistance, 12 (7), 2839-2851.

Leone, G., Pizzigallo, E. (2015). Bacterial infections following splenectomy for malignant and nonmalignant hematologic diseases. Mediterr J Hematol Infect Dis., 7 (1).

Montes, J. A. R. (2021). Splenectomy and sepsis. An RANM., 13 (8), 31-38.

Nascimento, I. F., et al. (2015). Immunoprophylaxis in splenectomized patients: a systematic review. Vita et Sanitas, 1 (7), 36-50.

Pasternack, M. D (2022). Prevention of infection in patients with impaired splenic function. UpToDate.

Picoita, F. et al. (2020). Post-splenectomy sepsis syndrome. Virtual Rev. Soc. Parag. Med. Int., 7 (2).

Premawardena, C., et. al. (2018). Understanding the significance and health implications of asplenia in a cohort of patients with hemoglobinopathy: possible benefits of a spleen registry. Hematology, 23 (8), 526-530.

Rezende, A. (2007). Influence of the spleen, asplenia and autogenous splenic implant on the lipid metabolism of mice. Rev. Col. Bras. Cir., 34 (3), 177-182.

Rubin, L. G., & Schaffner, W. (2014). Clinical practice. Care of the asplenic patient. N Engl J Med., 37 (4), 349-356.

Tahir, F., Ahmed, J., & Malik, F. (2020). Post-splenectomy Sepsis: A Review of the Literature. Cureus, 12 (2).

Taniguchi, L. U. (2014). Overwhelming post-splenectomy infection: narrative review of the literature. Surg Infect (Larchmt), 15 (7), 686–693.

Wang, J. et al. (2014). Adherence to infection prevention measures in a statewide spleen registry. Med J Aust., 200 (7), 538–540.

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Published

16/10/2023

How to Cite

ALMEIDA, M. G. de .; BARBOSA, D. R. M. Prevention of sepsis in patients with impaired splenic function. Research, Society and Development, [S. l.], v. 12, n. 10, p. e118121043583, 2023. DOI: 10.33448/rsd-v12i10.43583. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/43583. Acesso em: 14 may. 2024.

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Section

Health Sciences