[Supportive sepsis therapy: what is still valid today?].
Following several disappointing approaches to decrease the mortality of septic patients using various adjuncts, protein C is the first substance leading to a significant reduction of the mortality rate (PROWESS). The increased risk for bleeding complications in patients receiving protein C, however, limits its use in septic surgical patients. Administration of AT III in septic patients (KYBERSEPT) reduced the mortality rate solely in patients which were not treated with heparin. Although hydrocortisone reduced the amount of vasoactive katecholamines the effect of hydrocortisone administration on the survival rate remains unknown. In summary, early intervention to eliminate the septic focus and the use of antibiotics according to an antibiogramm still remains the most efficient basis for the treatment of septic patients.
Angele
M K
MK
Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Marchioninistrasse 15, 81377 München.
Faist
E
E
D000990:Antithrombin III / Q000008:administration & dosage / Q000009:adverse effects; D003422:Critical Care; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects; D011486:Protein C / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
D011486:Protein C; D000990:Antithrombin III; D006854:Hydrocortisone