Management of severe sepsis: integration of multiple pharmacologic interventions.
Severe sepsis is an infection-induced process that often promotes organ dysfunction and death in up to 50% of afflicted patients. Clinical advances that improve patient survival include early goal-directed volume resuscitation, broad-spectrum empiric antimicrobial therapy with deescalation strategies, therapy with drotrecogin alfa (activated), glucocorticoid replacement in patients with adrenal insufficiency, and tight control of blood glucose levels. The challenge for critical care practitioners is to integrate the many pharmacologic and supportive interventions required for optimal care of these patients.
Micek
Scott T
ST
Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA. stm8241@bjc.org
Shah
Rina A
RA
Kollef
Marin H
MH
D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000502:physiology; D019468:Disease Management; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology
D000890:Anti-Infective Agents; D001786:Blood Glucose; D005938:Glucocorticoids