Critical Appraisal of Therapeutic Interventions in the Intensive Care Unit: Human Monoclonal Antibody Treatment in Sepsis

@article{Cook1992CriticalAO,
  title={Critical Appraisal of Therapeutic Interventions in the Intensive Care Unit: Human Monoclonal Antibody Treatment in Sepsis},
  author={Deborah J. Cook and Roman Z. Jaeschke and Gordon H. Guyatt},
  journal={Journal of Intensive Care Medicine},
  year={1992},
  volume={7},
  pages={275 - 282}
}
Using the medical literature to solve patient problems is challenging and rewarding. For intensive care physicians, this evidence-based medicine approach is more compelling when basic critical appraisal skills are developed. We highlight the important methodological points for interpreting the literature on treatment, using a cogent example from the critical care literature—monoclonal antibody therapy in sepsis. It is likely that as we move into the 1990s, growth in the number in the number of… 

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References

SHOWING 1-10 OF 27 REFERENCES

Treatment of gram-negative shock.

  • J. Christy
  • Medicine
    The American journal of medicine
  • 1971

Treatment of Gram‐negative septic shock with an immunoglobulin preparation: A prospective, randomized clinical trial

Administration of a polyclonal immunoglobulin preparation in the early phase of septic shock was associated with significantly improved survival.

A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock.

It is concluded that the use of high-dose corticosteroids provides no benefit in the treatment of severe sepsis and septic shock.

Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group.

HA-1A is safe and effective for the treatment of patients with sepsis and gram-negative bacteremia and analyses that stratified according to the severity of illness at entry showed improved survival with HA- 1A treatment in both severely ill and less severely ill patients.

Initial evaluation of human monoclonal anti-lipid A antibody (HA-1A) in patients with sepsis syndrome.

The data indicate that the pharmacokinetics of HA-1A are well described by a one-compartment pharmacokinetic model, and that HA- 1A is safe and nonimmunogenic in patients with sepsis.

Clinical epidemiology : a basic science for clinical medicine

Clinical Epidemiology is a book dedicated to H.L. Mencken, Kurt Vonnegut, Jr., Douglas Adams, and the Emperor's New Clothes and Physicians and others who wish to recognize key clinical epidemiologic features of the diagnosis and management of patients will benefit from reading.

Sepsis syndrome: a valid clinical entity

The sepsis syndrome represents a systemic response to infection and is defined as hypothermia or hyperthermia, tachycardia, tachypnea, clinical evidence of an infection site and with at least one end-organ demonstrating inadequate perfusion or dysfunction expressed as poor or altered cerebral function.

The treatment of gram-negative bacteremia and shock.

  • S. Wolff
  • Medicine, Biology
    The New England journal of medicine
  • 1982
A large number of patients with gram-negative bacteremia are diagnosed with central giant cell granuloma, which is an important cause of morbidity and mortality, particularly in immunosuppressed patients.

An assessment of clinically useful measures of the consequences of treatment.

The goal is to provide a clear picture of the individual components of the immune system and provide a strategy for individualized treatment of these components according to their Kesslerian importance.