Infection in critically ill patients: clinical impact and management.
OBJECTIVE
The aim of this review is to summarize recent developments in the epidemiology, diagnosis and management of infection in critically ill patients.


RESULTS
New definitions of sepsis, including a grading system, similar to the tumor, node, metastasis system for cancer, have been suggested and are being developed. In terms of epidemiology, sepsis remains an important cause of morbidity and mortality among the critically ill, but the last couple of years have seen the development and licensing of a new immunomodulatory agent, drotrecogin-alpha (activated) that reduces mortality. Moderate doses of steroids have also been shown to improve outcomes for patients with septic shock.


CONCLUSIONS
Improved characterization of septic patients will help target and monitor new therapies. Newly developed immunomodulatory strategies and others currently undergoing clinical testing will help reduce the high mortality rates seen in this disease
Vincent
Jean-Louis
JL
Department of Intensive Care Medicine, Erasme Hospital, Free University of Brussels, Brussels, Belgium. jlvincen@ulb.ac.be
Jacobs
Frédérique
F
D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016638:Critical Illness; D006801:Humans; D017053:Infection Control; D011486:Protein C / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013256:Steroids
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D011486:Protein C; D011994:Recombinant Proteins; D013256:Steroids; C421124:drotrecogin alfa activated