[Focal surgery, antibiotic therapy--and then? The role of rhAPC in sepsis].
Severe sepsis and septic shock are still the leading causes of death in the surgical ICU. The only curative therapies of sepsis are still surgery as well as antibiotic therapy to cure the focus. In addition a supportive therapy (analgesia and sedation, mechanical ventilation, titrated volume substitution and positive inotropes/vasopressor support, parenteral and enteral neutron, renal replacement therapies) should be started as early as possible. A new promising approach in sepsis therapy is the application of rhAPC. The PROWESS study revealed a significantly lower 28 day mortality in patients with severe sepsis who received drotrecogin alfa (activated) compared to patients not treated with drotrecogin alfa (activated). Guidelines for the use in severe sepsis and septic shock in surgical patients (risk of bleeding, costs) are strongly recommended.
Spies
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Klinik für Anaesthesiologie und operative Intensivmedizin, Universitätsklinikum Charité, Campus Mitte, Schumannstrasse 20/21, 10117 Berlin. claudia.spies@charite.de
Otter
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Zuckermann-Becker
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Kox
W J
WJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D011486:Protein C / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use*; D012772:Shock, Septic / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000401:mortality / Q000601:surgery*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated
Fokussanierung, Antibiotikatherapie--und dann? Die Rolle von rhAPC in der Sepsis.