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Sepsis Syndromes

  • David E. Ciccolella
  • Michael S. Lagnese
Chapter

Abstract

After studying this chapter, you should be able to: Name the different sepsis syndromes. Understand how dysfunction of the host immune system contributes to development of the sepsis syndromes. Identify the hemodynamic and oxygen utilization abnormalities observed in septic patients. Recognize the clinical presentation and progression of the sepsis syndromes. Describe the intensive care unit (ICU) management of the sepsis syndromes.

Keywords

Septic Shock Severe Sepsis Systemic Inflammatory Response Syndrome Disseminate Intravascular Coagulation Systemic Vascular Resistance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

REFERENCES

  1. 1.
    Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992; 101:1644-1655.PubMedCrossRefGoogle Scholar
  2. 2.
    Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546-1554.PubMedCrossRefGoogle Scholar
  3. 3.
    Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699-709.PubMedCrossRefGoogle Scholar
  4. 4.
    Annane D, Aegerter P, Jars-Guincestre MC, Guidet B, CUB-Rea Network. Current epidemiology of septic shock: the CUB-Rea Network. Am J Respir Crit Care Med. 2003;168:165-172.PubMedCrossRefGoogle Scholar
  5. 5.
    Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med. 2003;31:1250-1256.PubMedCrossRefGoogle Scholar
  6. 6.
    Annane D, Bellissant E, Cavaillon JM. Septic shock. Lancet. 2005; 365:63-78.PubMedCrossRefGoogle Scholar
  7. 7.
    Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-1652.PubMedCrossRefGoogle Scholar
  8. 8.
    Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA. 1995;273:117-123.PubMedCrossRefGoogle Scholar
  9. 9.
    Wheeler AP, Bernard GR. Treating patients with severe sepsis. N Engl J Med. 1999;340:207-214.PubMedCrossRefGoogle Scholar
  10. 10.
    Aird WC. The hematologic system as a marker of organ dysfunction in sepsis. Mayo Clin Proc. 2003;78:869-881.PubMedCrossRefGoogle Scholar
  11. 11.
    Marshall JC, Charbonney E, Gonzalez PD. The immune system in critical illness. Clin Chest Med. 2008;29:605-616, vii.Google Scholar
  12. 12.
    Bianchi ME, Manfredi AA. Immunology. Dangers in and out. Science. 2009;323:1683-1684.PubMedCrossRefGoogle Scholar
  13. 13.
    Koch A, Zacharowski K. Toll-like receptor pathway signaling is differently regulated in neutrophils and peripheral mononuclear cells of patients with sepsis, severe sepsis, and septic shock. Crit Care Med. 2009;37:346-347.PubMedCrossRefGoogle Scholar
  14. 14.
    Granton JT, Walley KR, Phang PT, Russell JA, Lichtenstein S. Assessment of three methods to reduce the influence of mathematical coupling on oxygen consumption and delivery relationships. Chest. 1998;113:1347-1355.PubMedCrossRefGoogle Scholar
  15. 15.
    Russell JA. Adding fuel to the fire–the supranormal oxygen delivery trials controversy. Crit Care Med. 1998;26:981-983.PubMedCrossRefGoogle Scholar
  16. 16.
    Chittock DR, Russell JA. Oxygen delivery and consumption during sepsis. Clin Chest Med. 1996;17:263-278.PubMedCrossRefGoogle Scholar
  17. 17.
    Marik PE, Varon J. The hemodynamic derangements in sepsis: implications for treatment strategies. Chest. 1998;114:854-860.PubMedCrossRefGoogle Scholar
  18. 18.
    Landry DW, Oliver JA. The pathogenesis of vasodilatory shock. N Engl J Med. 2001;345:588-595.PubMedCrossRefGoogle Scholar
  19. 19.
    Ochoa JB, Udekwu AO, Billiar TR, et al. Nitrogen oxide levels in patients after trauma and during sepsis. Ann Surg. 1991;214:621-626.PubMedCrossRefGoogle Scholar
  20. 20.
    Vincent JL, Zhang H, Szabo C, Preiser JC. Effects of nitric oxide in septic shock. Am J Respir Crit Care Med. 2000;161:1781-1785.PubMedGoogle Scholar
  21. 21.
    Landry DW, Levin HR, Gallant EM, et al. Vasopressin deficiency contributes to the vasodilation of septic shock. Circulation. 1997; 95:1122-1125.PubMedCrossRefGoogle Scholar
  22. 22.
    Landry DW, Levin HR, Gallant EM, et al. Vasopressin pressor hypersensitivity in vasodilatory septic shock. Crit Care Med. 1997;25:1279-1282.PubMedCrossRefGoogle Scholar
  23. 23.
    Tsuneyoshi I, Yamada H, Kakihana Y, Nakamura M, Nakano Y, Boyle WA 3rd. Hemodynamic and metabolic effects of low-dose vasopressin infusions in vasodilatory septic shock. Crit Care Med. 2001;29:487-493.PubMedCrossRefGoogle Scholar
  24. 24.
    Malay MB, Ashton RC Jr, Landry DW, Townsend RN. Low-dose vasopressin in the treatment of vasodilatory septic shock. J Trauma. 1999;47:699-703; discussion 703-705.Google Scholar
  25. 25.
    Patel BM, Chittock DR, Russell JA, Walley KR. Beneficial effects of short-term vasopressin infusion during severe septic shock. Anesthesiology. 2002;96:576-582.PubMedCrossRefGoogle Scholar
  26. 26.
    Russell JA, Walley KR, Singer J, et al. Vasopressin versus norepinephrine infusion in patients with septic shock. N Engl J Med. 2008;358:877-887.PubMedCrossRefGoogle Scholar
  27. 27.
    Price S, Anning PB, Mitchell JA, Evans TW. Myocardial dysfunction in sepsis: mechanisms and therapeutic implications. Eur Heart J. 1999;20:715-724.PubMedCrossRefGoogle Scholar
  28. 28.
    Chan CM, Klinger JR. The right ventricle in sepsis. Clin Chest Med. 2008;29:661-676, ix.Google Scholar
  29. 29.
    Olivo G, Consales G, Michelagnoli G. Sepsis-associated cardiomyopathy. Curr Anaesth Crit Care. 2006;17:349-358.CrossRefGoogle Scholar
  30. 30.
    Fernandes CJ Jr, Akamine N, Knobel E. Cardiac troponin: a new serum marker of myocardial injury in sepsis. Intensive Care Med. 1999;25:1165-1168.PubMedCrossRefGoogle Scholar
  31. 31.
    Hoffmann JN, Werdan K, Hartl WH, Jochum M, Faist E, Inthorn D. Hemofiltrate from patients with severe sepsis and depressed left ventricular contractility contains cardiotoxic compounds. Shock. 1999;12:174-180.PubMedCrossRefGoogle Scholar
  32. 32.
    Richard C, Warszawski J, Anguel N, et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2003;290:2713-2720.PubMedCrossRefGoogle Scholar
  33. 33.
    National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med. 2006;354:2213-2224.CrossRefGoogle Scholar
  34. 34.
    Harvey S, Harrison DA, Singer M, et al. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomized controlled trial. Lancet. 2005;366:472-477.PubMedCrossRefGoogle Scholar
  35. 35.
    Rivers EP, Coba V, Visbal A, Whitmill M, Amponsah D. Management of sepsis: early resuscitation. Clin Chest Med. 2008;29:689-704, ix-x.Google Scholar
  36. 36.
    Parrillo JE, Parker MM, Natanson C, et al. Septic shock in humans. Advances in the understanding of pathogenesis, cardiovascular dysfunction, and therapy. Ann Intern Med. 1990;113:227-242.PubMedGoogle Scholar
  37. 37.
    Parker MM, McCarthy KE, Ognibene FP, Parrillo JE. Right ventricular dysfunction and dilatation, similar to left ventricular changes, characterize the cardiac depression of septic shock in humans. Chest. 1990;97:126-131.PubMedCrossRefGoogle Scholar
  38. 38.
    Parrillo JE. Myocardial depression during septic shock in humans. Crit Care Med. 1990;18:1183-1184.PubMedCrossRefGoogle Scholar
  39. 39.
    Schrier RW, Wang W. Acute renal failure and sepsis. N Engl J Med. 2004;351:159-169.PubMedCrossRefGoogle Scholar
  40. 40.
    Siami S, Annane D, Sharshar T. The encephalopathy in sepsis. Crit Care Clin. 2008;24:67-82, viii.Google Scholar
  41. 41.
    Pustavoitau A, Stevens RD. Mechanisms of neurologic failure in critical illness. Crit Care Clin. 2008;24:1-24, vii.Google Scholar
  42. 42.
    Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001; 286:2703-2710.PubMedCrossRefGoogle Scholar
  43. 43.
    Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics. 1996;37:533-546.PubMedCrossRefGoogle Scholar
  44. 44.
    Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med. 2001;27:859-864.PubMedCrossRefGoogle Scholar
  45. 45.
    Peres Bota D, Lopes Ferreira F, Melot C, Vincent JL. Body temperature alterations in the critically ill. Intensive Care Med. 2004;30:811-816.PubMedCrossRefGoogle Scholar
  46. 46.
    Georges H, Leroy O, Vandenbussche C, et al. Epidemiological features and prognosis of severe community-acquired pneumococcal pneumonia. Intensive Care Med. 1999;25:198-206.PubMedCrossRefGoogle Scholar
  47. 47.
    Levi M, ten Cate H, van der Poll T, van Deventer SJ. Pathogenesis of disseminated intravascular coagulation in sepsis. JAMA. 1993;270:975-979.PubMedCrossRefGoogle Scholar
  48. 48.
    Levi M. The coagulant response in sepsis. Clin Chest Med. 2008; 29:627-642, viii.Google Scholar
  49. 49.
    Levi M, de Jonge E, van der Poll T. Sepsis and disseminated intravascular coagulation. J Thromb Thrombolysis. 2003;16:43-47.PubMedCrossRefGoogle Scholar
  50. 50.
    Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M, Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH). Toward definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001; 86:1327-1330.PubMedGoogle Scholar
  51. 51.
    Mavrommatis AC, Theodoridis T, Orfanidou A, Roussos C, Christopoulou-Kokkinou V, Zakynthinos S. Coagulation system and platelets are fully activated in uncomplicated sepsis. Crit Care Med. 2000;28:451-457.PubMedCrossRefGoogle Scholar
  52. 52.
    Akca S, Haji-Michael P, de Mendonca A, Suter P, Levi M, Vincent JL. Time course of platelet counts in critically ill patients. Crit Care Med. 2002;30:753-756.PubMedCrossRefGoogle Scholar
  53. 53.
    Warkentin TE, Aird WC, Rand JH. Platelet–endothelial interactions: sepsis, HIT, and antiphospholipid syndrome. Hematology Am Soc Hematol Educ Program. 2003;497-519.Google Scholar
  54. 54.
    Levi M. Platelets. Crit Care Med. 2005;33:S523-S525.PubMedCrossRefGoogle Scholar
  55. 55.
    Chakraverty R, Davidson S, Peggs K, Stross P, Garrard C, Littlewood TJ. The incidence and cause of coagulopathies in an intensive care population. Br J Haematol. 1996;93:460-463.PubMedCrossRefGoogle Scholar
  56. 56.
    MacLeod JB, Lynn M, McKenney MG, Cohn SM, Murtha M. Early coagulopathy predicts mortality in trauma. J Trauma. 2003;55:39-44.PubMedCrossRefGoogle Scholar
  57. 57.
    Shorr AF, Thomas SJ, Alkins SA, Fitzpatrick TM, Ling GS. D-dimer correlates with proinflammatory cytokine levels and outcomes in critically ill patients. Chest. 2002;121:1262-1268.PubMedCrossRefGoogle Scholar
  58. 58.
    Owings JT, Gosselin RC, Anderson JT, Battistella FD, Bagley M, Larkin EC. Practical utility of the D-dimer assay for excluding thromboembolism in severely injured trauma patients. J Trauma. 2001;51:425-429; discussion 429-430.Google Scholar
  59. 59.
    Gando S, Nanzaki S, Sasaki S, Kemmotsu O. Significant correlations between tissue factor and thrombin markers in trauma and septic patients with disseminated intravascular coagulation. Thromb Haemost. 1998;79:1111-1115.PubMedGoogle Scholar
  60. 60.
    Russell JA. Management of sepsis. N Engl J Med. 2006;355:1699-1713.PubMedCrossRefGoogle Scholar
  61. 61.
    Ruf W, Edgington TS. Structural biology of tissue factor, the initiator of thrombogenesis in vivo. FASEB J. 1994;8:385-390.PubMedGoogle Scholar
  62. 62.
    Franco RF, de Jonge E, Dekkers PE, et al. The in vivo kinetics of tissue factor messenger RNA expression during human endotoxemia: relationship with activation of coagulation. Blood. 2000;96:554-559.PubMedGoogle Scholar
  63. 63.
    van Deventer SJ, Buller HR, ten Cate JW, Aarden LA, Hack CE, Sturk A. Experimental endotoxemia in humans: analysis of cytokine release and coagulation, fibrinolytic, and complement pathways. Blood. 1990;76:2520-2526.PubMedGoogle Scholar
  64. 64.
    van der Poll T, Buller HR, ten Cate H, et al. Activation of coagulation after administration of tumor necrosis factor to normal subjects. N Engl J Med. 1990;322:1622-1627.PubMedCrossRefGoogle Scholar
  65. 65.
    Levi M, ten Cate H, Bauer KA, et al. Inhibition of endotoxin-induced activation of coagulation and fibrinolysis by pentoxifylline or by a monoclonal anti-tissue factor antibody in chimpanzees. J Clin Invest. 1994;93:114-120.PubMedCrossRefGoogle Scholar
  66. 66.
    Biemond BJ, Levi M, ten Cate H, et al. Complete inhibition of endotoxin-induced coagulation activation in chimpanzees with a monoclonal Fab fragment against factor VII/VIIa. Thromb Haemost. 1995; 73:223-230.PubMedGoogle Scholar
  67. 67.
    Martin JB, Wheeler AP. Approach to the patient with sepsis. Clin Chest Med. 2009;30:1-16, vii.Google Scholar
  68. 68.
    Saberi F, Heyland D, Lam M, Rapson D, Jeejeebhoy K. Prevalence, incidence, and clinical resolution of insulin resistance in critically ill patients: an observational study. JPEN J Parenter Enteral Nutr. 2008;32:227-235.PubMedCrossRefGoogle Scholar
  69. 69.
    McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin. 2001;17:107-124.PubMedCrossRefGoogle Scholar
  70. 70.
    Warren HS, Suffredini AF, Eichacker PQ, Munford RS. Risks and benefits of activated protein C treatment for severe sepsis. N Engl J Med. 2002;347:1027-1030.PubMedCrossRefGoogle Scholar
  71. 71.
    Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C. Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med. 2003;31:2742-2751.PubMedCrossRefGoogle Scholar
  72. 72.
    Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000;118:146-155.PubMedCrossRefGoogle Scholar
  73. 73.
    Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34:1589-1596.PubMedCrossRefGoogle Scholar
  74. 74.
    Schramm GE, Johnson JA, Doherty JA, Micek ST, Kollef MH. Methicillin-resistant Staphylococcus aureus sterile-site infection: the importance of appropriate initial antimicrobial treatment. Crit Care Med. 2006;34:2069-2074.PubMedCrossRefGoogle Scholar
  75. 75.
    Dellinger RP, Levy MM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296-327.PubMedCrossRefGoogle Scholar
  76. 76.
    Annane D. ICU physicians should abandon the use of etomidate! Intensive Care Med. 2005;31:325-326.PubMedCrossRefGoogle Scholar
  77. 77.
    Wagner RL, White PF, Kan PB, Rosenthal MH, Feldman D. Inhibition of adrenal steroidogenesis by the anesthetic etomidate. N Engl J Med. 1984;310:1415-1421.PubMedCrossRefGoogle Scholar
  78. 78.
    Tekwani KL, Watts HF, Rzechula KH, Sweis RT, Kulstad EB. A prospective observational study of the effect of etomidate on septic patient mortality and length of stay. Acad Emerg Med. 2009;16:11-14.PubMedCrossRefGoogle Scholar
  79. 79.
    Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377.PubMedCrossRefGoogle Scholar
  80. 80.
    Thiel SW, Asghar MF, Micek ST, Reichley RM, Doherty JA, Kollef MH. Hospital-wide impact of a standardized order set for the management of bacteremic severe sepsis. Crit Care Med. 2009;37:819-824.PubMedCrossRefGoogle Scholar
  81. 81.
    Kortgen A, Niederprum P, Bauer M. Implementation of an evidence-based “standard operating procedure” and outcome in septic shock. Crit Care Med. 2006;34:943-949.PubMedCrossRefGoogle Scholar
  82. 82.
    Shapiro NI, Howell MD, Talmor D, et al. Implementation and outcomes of the multiple urgent sepsis therapies (MUST) protocol. Crit Care Med. 2006;34:1025-1032.PubMedCrossRefGoogle Scholar
  83. 83.
    Micek ST, Roubinian N, Heuring T, et al. Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med. 2006;34:2707-2713.PubMedCrossRefGoogle Scholar
  84. 84.
    Rivers EP, Kruse JA, Jacobsen G, et al. The influence of early hemodynamic optimization on biomarker patterns of severe sepsis and septic shock. Crit Care Med. 2007;35:2016-2024.PubMedCrossRefGoogle Scholar
  85. 85.
    Bendjelid K, Romand JA. Fluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care. Intensive Care Med. 2003;29:352-360.PubMedCrossRefGoogle Scholar
  86. 86.
    Malbrain ML, Deeren D, De Potter TJ. Intra-abdominal hypertension in the critically ill: it is time to pay attention. Curr Opin Crit Care. 2005;11:156-171.PubMedCrossRefGoogle Scholar
  87. 87.
    Choi PT, Yip G, Quinonez LG, Cook DJ. Crystalloids vs. colloids in fluid resuscitation: a systematic review. Crit Care Med. 1999;27:200-210.PubMedCrossRefGoogle Scholar
  88. 88.
    Wilkes MM, Navickis RJ. Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials. Ann Intern Med. 2001;135:149-164.PubMedGoogle Scholar
  89. 89.
    Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247-2256.PubMedCrossRefGoogle Scholar
  90. 90.
    Kumar A, Anel R, Bunnell E, et al. Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects. Crit Care Med. 2004;32:691-699.PubMedCrossRefGoogle Scholar
  91. 91.
    Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med. 2007;35:64-68.PubMedCrossRefGoogle Scholar
  92. 92.
    Pinsky MR. Hemodynamic evaluation and monitoring in the ICU. Chest. 2007;132:2020-2029.PubMedCrossRefGoogle Scholar
  93. 93.
    Durairaj L, Schmidt GA. Fluid therapy in resuscitated sepsis: less is more. Chest. 2008;133:252-263.PubMedCrossRefGoogle Scholar
  94. 94.
    Vincent JL, Weil MH. Fluid challenge revisited. Crit Care Med. 2006;34:1333-1337.PubMedCrossRefGoogle Scholar
  95. 95.
    Levy MM, Macias WL, Vincent JL, et al. Early changes in organ function predict eventual survival in severe sepsis. Crit Care Med. 2005;33:2194-2201.PubMedCrossRefGoogle Scholar
  96. 96.
    LeDoux D, Astiz ME, Carpati CM, Rackow EC. Effects of perfusion pressure on tissue perfusion in septic shock. Crit Care Med. 2000;28:2729-2732.PubMedCrossRefGoogle Scholar
  97. 97.
    Mullner M, Urbanek B, Havel C, Losert H, Waechter F, Gamper G. Vasopressors for shock. Cochrane Database Syst Rev. 2004;(3): CD003709.Google Scholar
  98. 98.
    Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296-327.PubMedCrossRefGoogle Scholar
  99. 99.
    Hollenberg SM. Vasopressor support in septic shock. Chest. 2007;132:1678-1687.PubMedCrossRefGoogle Scholar
  100. 100.
    Asfar P, Hauser B, Radermacher P, Matejovic M. Catecholamines and vasopressin during critical illness. Crit Care Clin. 2006;22:131-149, vii-viii.Google Scholar
  101. 101.
    Schetz M. Vasopressors and the kidney. Blood Purif. 2002;20:243-251.PubMedCrossRefGoogle Scholar
  102. 102.
    Albanese J, Leone M, Garnier F, Bourgoin A, Antonini F, Martin C. Renal effects of norepinephrine in septic and nonseptic patients. Chest. 2004;126:534-539.PubMedCrossRefGoogle Scholar
  103. 103.
    De Backer D, Creteur J, Silva E, Vincent JL. Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best? Crit Care Med. 2003;31:1659-1667.PubMedCrossRefGoogle Scholar
  104. 104.
    Levy B, Bollaert PE, Charpentier C, et al. Comparison of norepinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: a prospective, randomized study. Intensive Care Med. 1997;23:282-287.PubMedCrossRefGoogle Scholar
  105. 105.
    Meier-Hellmann A, Reinhart K, Bredle DL, Specht M, Spies CD, Hannemann L. Epinephrine impairs splanchnic perfusion in septic shock. Crit Care Med. 1997;25:399-404.PubMedCrossRefGoogle Scholar
  106. 106.
    Annane D, Vignon P, Renault A, et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomized trial. Lancet. 2007;370:676-684.PubMedCrossRefGoogle Scholar
  107. 107.
    Gregory JS, Bonfiglio MF, Dasta JF, Reilley TE, Townsend MC, Flancbaum L. Experience with phenylephrine as a component of the pharmacologic support of septic shock. Crit Care Med. 1991;19:1395-1400.PubMedCrossRefGoogle Scholar
  108. 108.
    DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill; 2008:2581.Google Scholar
  109. 109.
    Reinelt H, Radermacher P, Kiefer P, et al. Impact of exogenous beta-adrenergic receptor stimulation on hepatosplanchnic oxygen kinetics and metabolic activity in septic shock. Crit Care Med. 1999; 27:325-331.PubMedCrossRefGoogle Scholar
  110. 110.
    Vincent JL, Gris P, Coffernils M, et al. Myocardial depression characterizes the fatal course of septic shock. Surgery. 1992;111:660-667.PubMedGoogle Scholar
  111. 111.
    Pinsky MR, Payen D. Functional hemodynamic monitoring. Crit Care. 2005;9:566-572.PubMedCrossRefGoogle Scholar
  112. 112.
    Monnet X, Osman D, Ridel C, Lamia B, Richard C, Teboul JL. Predicting volume responsiveness by using the end-expiratory occlusion in mechanically ventilated intensive care unit patients. Crit Care Med. 2009;37:951-956.PubMedCrossRefGoogle Scholar
  113. 113.
    Jabot J, Teboul JL, Richard C, Monnet X. Passive leg raising for predicting fluid responsiveness: importance of the postural change. Intensive Care Med. 2009;35:85-90.PubMedCrossRefGoogle Scholar
  114. 114.
    Monnet X, Rienzo M, Osman D, et al. Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med. 2006;34:1402-1407.PubMedCrossRefGoogle Scholar
  115. 115.
    Michard F, Boussat S, Chemla D, et al. Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med. 2000;162:134-138.PubMedGoogle Scholar
  116. 116.
    Abraham E. Coagulation abnormalities in acute lung injury and sepsis. Am J Respir Cell Mol Biol. 2000;22:401-404.PubMedGoogle Scholar
  117. 117.
    Ettingshausen CE, Veldmann A, Beeg T, Schneider W, Jager G, Kreuz W. Replacement therapy with protein C concentrate in infants and adolescents with meningococcal sepsis and purpura fulminans. Semin Thromb Hemost. 1999;25:537-541.PubMedCrossRefGoogle Scholar
  118. 118.
    Levi M, de Jonge E, van der Poll T. Rationale for restoration of physiological anticoagulant pathways in patients with sepsis and disseminated intravascular coagulation. Crit Care Med. 2001;29:S90-S94.PubMedCrossRefGoogle Scholar
  119. 119.
    Vincent JL, Angus DC, Artigas A, et al. Effects of drotrecogin alfa (activated) on organ dysfunction in the PROWESS trial. Crit Care Med. 2003;31:834-840.PubMedCrossRefGoogle Scholar
  120. 120.
    Finfer S, Ranieri VM, Thompson BT, et al. Design, conduct, analysis, and reporting of a multi-national placebo-controlled trial of activated protein C for persistent septic shock. Intensive Care Med. 2008;34:1935-1947.PubMedCrossRefGoogle Scholar
  121. 121.
    Abraham E, Laterre PF, Garg R, et al. Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med. 2005;353:1332-1341.PubMedCrossRefGoogle Scholar
  122. 122.
    Nadel S, Goldstein B, Williams MD, et al. Drotrecogin alfa (activated) in children with severe sepsis: a multi-centre phase III randomized controlled trial. Lancet. 2007;369:836-843.PubMedCrossRefGoogle Scholar
  123. 123.
    Manns BJ, Lee H, Doig CJ, Johnson D, Donaldson C. An economic evaluation of activated protein C treatment for severe sepsis. N Engl J Med. 2002;347:993-1000.PubMedCrossRefGoogle Scholar
  124. 124.
    Angus DC, Linde-Zwirble WT, Clermont G, et al. Cost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis. Crit Care Med. 2003;31:1-11.PubMedCrossRefGoogle Scholar
  125. 125.
    Vincent JL, Bernard GR, Beale R, et al. Drotrecogin alfa (activated) treatment in severe sepsis from the global open-label trial ENHANCE: further evidence for survival and safety and implications for early treatment. Crit Care Med. 2005;33:2266-2277.PubMedCrossRefGoogle Scholar
  126. 126.
    Gentry CA, Gross KB, Sud B, Drevets DA. Adverse outcomes associated with the use of drotrecogin alfa (activated) in patients with severe sepsis and baseline bleeding precautions. Crit Care Med. 2009;37:19-25.PubMedCrossRefGoogle Scholar
  127. 127.
    Sweeney DA, Natanson C, Eichacker PQ. Recombinant human activated protein C, package labeling, and hemorrhage risks. Crit Care Med. 2009;37:327-329.PubMedCrossRefGoogle Scholar
  128. 128.
    Bone RC, Fisher CJ Jr, Clemmer TP, Slotman GJ, Metz CA, Balk RA. A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med. 1987;317:653-658.PubMedCrossRefGoogle Scholar
  129. 129.
    Anon. Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. The Veterans Administration Systemic Sepsis Cooperative Study Group. N Engl J Med. 1987;317:659-665.Google Scholar
  130. 130.
    Finfer S. Corticosteroids in septic shock. N Engl J Med. 2008; 358:188-190.PubMedCrossRefGoogle Scholar
  131. 131.
    Marik PE, Pastores SM, Annane D, et al. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: Consensus statements from an international task force by the American College of Critical Care Medicine. Crit Care Med. 2008;36:1937-1949.PubMedCrossRefGoogle Scholar

ADDITIONAL READING

  1. Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008;36:296-327.PubMedCrossRefGoogle Scholar
  2. Marik PE, Varon J. The hemodynamic derangements in sepsis. Implications for treatment strategies. Chest. 1998;114:854-860.PubMedCrossRefGoogle Scholar
  3. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med. 2006;354:2213-2224.Google Scholar
  4. Annane D, Bellissant E, Cavaillon JM. Septic shock. Lancet. 2005; 365:63-78.PubMedCrossRefGoogle Scholar
  5. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377.PubMedCrossRefGoogle Scholar
  6. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564-2575.Google Scholar
  7. Durairaj L, Schmidt GA. Fluid therapy in resuscitated sepsis: less is more. Chest. 2008;133:252-263.PubMedCrossRefGoogle Scholar
  8. Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350:2247-2256.PubMedCrossRefGoogle Scholar
  9. American Thoracic Society. Evidence-based colloid use in the critically ill: American Thoracic Society Consensus Statement. Am J Respir Crit Care Med. 2004;170:1247-1259.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • David E. Ciccolella
    • 1
  • Michael S. Lagnese
    • 2
  1. 1.Respiratory Therapy, Division of Pulmonary and Critical Care MedicineTemple University School of MedicinePhiladelphiaUSA
  2. 2.Division of Pulmonary and Critical Care MedicineChestnut Hill Health SystemPhiladelphiaUSA

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