[New therapeutic strategies in severe sepsis and septic shock].
Severe sepsis and septic shock are an important cause of mortality. Until recently, in spite of major progresses in our understanding of the pathogenic mechanisms of this syndrome, clinicians had only a limited therapeutic arsenal. Considerable efforts have been made in the past few years to develop novel therapeutic interventions to reduce mortality in sepsis. So far, five specific therapies have proven their efficacy to achieve such goal in large randomised controlled trials: early goal-directed therapy, recombinant activated protein C, moderate doses of steroids, low tidal volume ventilation in acute respiratory distress syndrome and intensive insulin therapy to control hyperglycemia. This review will focus on these recently acquired therapeutic modalities, that are presently available to clinicians for the treatment of severe sepsis and septic shock.
Oddo
Mauro
M
Division des Soins Intensifs, Département de Médecine, Interne CHUV, Lausanne. mauro.oddo@chuv.hospvd.ch
Schaller
Marie-Denise
MD
Calandra
Thierry
T
Liaudet
Lucas
L
D006801:Humans; D012151:Resuscitation; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000401:mortality / Q000628:therapy*