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Hemofiltration in Sepsis and Septic Shock

  • P. Rogiers
  • H. Zhang
  • J.-L. Vincent
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1997)

Abstract

Sepsis and septic shock are leading causes of morbidity and mortality in the intensive care setting. The mortality rate in patients with septic shock ranges from 40 to 80%. The primary therapeutic strategy for septic shock involves, on the one hand, hemodynamic stabilization including restoration of blood pressure, and optimization of oxygen delivery [1, 2], and on the other hand, administration of antibiotics together with removal of the septic source whenever indicated. Several clinical studies have demonstrated a close relationship between the severity of sepsis, mortality rate, and the release of cytokines including tumor necrosis factor (TNF), and interleukins (IL)-1, IL-6, and IL-8 [3–6]. The release of various mediators can be involved in reduction in myocardial contractility, increase in oxygen demand, and alteration in oxygen extraction capabilities during septic shock [7]. Modulation of the immune response is therefore considered as another important therapeutic intervention. A number of clinical trials investigating the effects of anti-endotoxin, or anti-cytokine interventions did not consistently show an improvement in survival in patients with sepsis or septic shock [8, 9]. Importantly, various factors such as inclusion criteria, dose, and timing could influence the results. Moreover, a single immunotherapy may not be sufficient to blunt the inflammatory and immunological process, so that a combination of therapies may be necessary to improve outcome from septic shock.

Keywords

Septic Shock Acute Renal Failure Mean Arterial Pressure Endotoxic Shock Arachidonic Acid Metabolite 
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.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • P. Rogiers
  • H. Zhang
  • J.-L. Vincent

There are no affiliations available

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