[Protocols for treatment of multiple organ dysfunction syndrome/severe sepsis combined of traditional Chinese medicine and Western medicine].
OBJECTIVE
In 2003, European critical care experts have drafted surviving sepsis campaign (SSC) guidelines for therapy of sepsis, and it would be of practical use for the clinician, but case mortality of severe sepsis was expected to lower obviously. Our effort is to draft our guidelines of combining traditional Chinese medicine and western medicine as a supplement to SSC guidelines.


METHODS
On evidence-based medicine, We undertook some large-sample randomized clinical trials in immunity regulation, anticoagulant therapy, promoting motility of intestinal tract in patients with severe sepsis and mechanical ventilation for acute respiratory distress syndrome (ARDS). The modified Delphi methodology was used for grading recommendations.


RESULTS
It was essential to control the primary disease in multiple organ dysfunction syndrome (MODS). Our four recommendations were graded B according to the modified Delphi methodology. First, modulation of immunity benefitted MODS/severe sepsis; second, early anticoagulant therapy was essential to MODS/severe sepsis, because disseminated intravascular coagulopathy occurred in 44.1% of MODS; third, Chinese herb medicines could promote and protect gastrointestinal function in MODS/severe sepsis; fourth, institution of mechanical ventilation with low tidal volume (VT) was effective and safe in ARDS.


CONCLUSIONS
The present guidelines supplements some pertinent problems which were neglected in SSC guidelines for the management of MODS/severe sepsis, and they may hopefully improve the outcome of the critically ill patient. The guidelines will be updated when some important new knowledge becomes available.
D006801:Humans; D008516:Medicine, Chinese Traditional; D009102:Multiple Organ Failure / Q000628:therapy*; D018805:Sepsis / Q000628:therapy*