| New concepts in treatment of sepsis. | |
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MedLine Citation:
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PMID: 15449442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Critically ill patients still commonly die of the effects of sepsis, despite numerous interventions. Earlier trials investigated mostly anti-inflammatory strategies, based on the prevailing theory that sepsis represents an uncontrolled inflammatory response. We now know that sepsis represents a biphasic response to infection, and the initial pro-inflammatory response that we have targeted thus far is invariably followed by a prolonged period of immune suppression. Indeed, a patient may oscillate between a pro- and anti-inflammatory state repeatedly. The use of steroids remains controversial, and should probably be reserved for a select subset of patients. The coagulation cascade has a powerful effect on inflammation, and manipulation by means of Activated Protein C has been beneficial. It appears tremendously advantageous to resuscitate the critically ill patient early and aggressively to maintain normal oxidative metabolism. This, coupled with the rigorous maintenance of a physiologically neutral milieu (particularly blood glucose levels) seems to be the most powerful weapon we have to manage the critically ill patient with sepsis. |
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Authors:
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P le Roux |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging Volume: 59 ISSN: 1029-4864 ISO Abbreviation: SADJ Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-09-28 Completed Date: 2004-10-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9812497 Medline TA: SADJ Country: South Africa |
Other Details:
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Languages: eng Pagination: 208-9 Citation Subset: D |
Affiliation:
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Department of Anaesthesiology and Intensive Care, University of Stellenbosch. pleroux@intekom.co.za |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Inflammatory Agents
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therapeutic use Anticoagulants / therapeutic use Blood Coagulation / drug effects Blood Glucose / analysis Cause of Death Critical Care Critical Illness* Glucocorticoids / therapeutic use Humans Immunocompromised Host / immunology Oxidation-Reduction Protein C / therapeutic use Sepsis / immunology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents; 0/Anticoagulants; 0/Blood Glucose; 0/Glucocorticoids; 0/Protein C |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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