title: Novel therapies for septic shock over the past 4 decades.
abstract: Infections that result in shock and organ failure are a major public health problem worldwide. Severe sepsis and septic shock affect patients of all ages and often complicate chronic diseases. They are the major causes of death in critical care units and contribute substantially to hospital inpatient costs. Translating the scientific advances of the last 4 decades into clinical practice has been challenging. Despite many attempts to develop new therapies, the basic elements of treatment have not changed since the 1960s. In this Grand Rounds, we summarize the results of the clinical trials conducted during the last 4 decades, discuss some lessons learned, and suggest possible directions for future investigation.
authors.affiliation: Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bldg 10, Rm 2C145, Bethesda, MD 20892, USA. asuffredini@cc.nih.gov
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Suffredini
authors.forename: Robert S
authors.initials: RS
authors.lastname: Munford
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D016470:Bacteremia; D009202:Cardiomyopathies / Q000139:chemically induced; D002986:Clinical Trials as Topic; D004358:Drug Therapy / Q000266:history; D004731:Endotoxins / Q000037:antagonists & inhibitors; D016984:Enterococcus faecium / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000209:etiology; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D016867:Immunocompromised Host; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000628:therapy; D009503:Neutropenia; D012772:Shock, Septic / Q000209:etiology / Q000628:therapy*; D033581:Stem Cell Transplantation; D057049:Thrombotic Microangiopathies / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D004731:Endotoxins; D005938:Glucocorticoids