Modern approaches to the therapy of septic shock.
Bacteremia from gram-negative rods is a great cause of concern for hospital physicians today. Shock-complicating gram-negative sepsis has a mortality rate of 60% and above, despite early diagnosis and treatment. Intensive research efforts have shown new pathophysiological mechanisms and mediators involved in septic shock, with changes in recommended treatment protocols. In this report, the authors review the use of corticosteroids, fibronectin, naloxone hydrochloride, and immunotherapy, with emphasis on theoretical considerations and relevant clinical experience. Although these treatment methods may have been promising initially, data from large double-blind human trials are either lacking or unencouraging. While continued research and modern therapeutic approaches should improve future survival rates from septic shock, use of the therapies reviewed should be considered experimental at this time.
Department of Internal Medicine A, Haddassah University Hospital--Eim Kerum, Jerusalem, Israel.
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Putterman
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005353:Fibronectins / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D009270:Naloxone / Q000627:therapeutic use; D012772:Shock, Septic / Q000188:drug therapy / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D005353:Fibronectins; D009270:Naloxone