Management of severe sepsis: advances, challenges, and current status.
The complexity of treating severe sepsis and septic shock has been elucidated in myriad studies, particularly in the past 10 years. The development of clinical guidelines, insight into the effect of bundle elements, and results of clinical trials have brought to light further opportunities and questions in the approach to pharmaceutical interventions for the global challenge to save lives and reduce healthcare costs. Therapeutic interventions including fluid resuscitation, hemodynamic monitoring, glycemic control, corticosteroids, and antimicrobial therapy and stewardship inform outcomes. Research on biomarkers, use of mesenchymal stem cells, blood purification, immunoglobulins, and antioxidative treatments apropos the immune response may soon yield viable therapies.
Multidisciplinary Intensive Care Research Organization (MICRO), St James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland.
Ignacio
I
Martin-Loeches
Brown University, Providence, RI, USA.
Mitchell M
MM
Levy
Critical Care Center, CIBER Enfermedades Respiratorias, Sabadell Hospital, Corporació Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona, Barcelona, Spain.
Antonio
A
Artigas
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers; D017408:Guidelines as Topic; D006801:Humans; D018805:Sepsis / Q000453:epidemiology / Q000628:therapy*; D012772:Shock, Septic / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D015415:Biomarkers
biomarkers; critical care; guidelines; sepsis; septic shock; surviving sepsis campaign