Therapy of Septic Shock: New Strategies
The high frequency and often devastating consequences of sepsis make it a major cause of death from infection in the United States today . Although bacteremia may be asymptomatic, it too often comes to clinical attention as an acute catastrophic event recognized by a characteristic constellation of signs and symptoms. Indeed, the term sepsis implies bacteremia coupled with a host response to the circulating microorganisms. Factors that determine the presence or absence of clinical symptoms are largely unknown, though they are of obvious importance in the therapy of bacteremic patients. Conversely, several clinical and laboratory features of bacteremic patients mitigate for or against survival and the development of a particularly devastating manifestation of sepsis, the adult respiratory distress syndrome (ARDS). This review will discuss risk factors, incidence, and prognostic indicators of sepsis and septic ARDS, and conclude with a brief review of two controversial aspects of therapy for septic lung injury: corticosteroids and prophylactic positive end expiratory pressure (PEEP).
KeywordsPlacebo Lactate Corticosteroid Bacillus Angiotensin
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