Treatment options for severe sepsis and septic shock.
Despite significant advances in the understanding of the pathophysiology of sepsis, severe sepsis and septic shock continue to be associated with high morbidity and mortality. Eradication of infection, with appropriate antibiotics and source control, remains the cornerstone of sepsis management, but does not ensure survival. Aggressive supportive care, such as fluid resuscitation, vasoactive agents or mechanical ventilation, is often required. With the exception of drotrecogin alfa, attempts to modulate the inflammatory response in sepsis have generally been unsuccessful. Early goal-directed therapy targeting adequate central venous oxygen saturation appears to improve outcome. Recently, there has been renewed interest in the use of corticosteroids, not as anti-inflammatory agents, but as replacement therapy. There is also some evidence to suggest that tight glucose control may improve outcome in these patients.
Sharma
Vinay K
VK
Medical Intensive Care Unit, The Graduate Hospital & Clinical Assistant Professor of Medicine, Drexel University College of Medicine, Pepper Pavilion, Suite 607, 1800 Lombard Street, Philadelphia, PA 19144, USA. vinayks@yahoo.com
Dellinger
R Phillip
RP
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D006801:Humans; D011486:Protein C / Q000627:therapeutic use; D012151:Resuscitation; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014667:Vasopressins / Q000502:physiology
D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D011486:Protein C; D014662:Vasoconstrictor Agents; D014667:Vasopressins