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.
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Rogiers, P., Zhang, H., Vincent, JL. (1997). Hemofiltration in Sepsis and Septic Shock. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1997. Yearbook of Intensive Care and Emergency Medicine, vol 1997. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13450-4_13
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DOI: https://doi.org/10.1007/978-3-662-13450-4_13
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