Controversies in the treatment of sepsis.
Sepsis is a common illness of intensive care unit patients that carries a high morbidity, mortality, and increases hospital cost. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. Many interventions, such as early appropriate antibiotic therapy and lung protective, low tidal volume ventilation are commonplace and carry little controversy in their benefit. However, other therapies still have an unclear benefit and remain controversial. This article discusses the controversial roles of intensive insulin therapy, corticosteroids, and activated protein C in the treatment of sepsis.
Sandrock
Christian E
CE
Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Clinical Medicine, University of California Davis School of Medicine, Sacramento, CA95817, USA. cesandrock@ucdavis.edu
Albertson
Timothy E
TE
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003422:Critical Care / Q000191:economics / Q000379:methods*; D005938:Glucocorticoids / Q000627:therapeutic use; D017721:Hospital Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D011486:Protein C / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000379:methods; D018805:Sepsis / Q000191:economics / Q000401:mortality / Q000628:therapy*
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D007004:Hypoglycemic Agents; D007328:Insulin; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated