The pathophysiology and treatment of sepsis.

@article{Hotchkiss2003ThePA,
  title={The pathophysiology and treatment of sepsis.},
  author={Richard S Hotchkiss and Irene E. Karl},
  journal={The New England journal of medicine},
  year={2003},
  volume={348 2},
  pages={
          138-50
        }
}
Sepsis is the leading cause of death in critically ill patients in the United States. Yet the individual host response to septicemia is variable, depending on the patient's immune response, age, nutritional status, and coexisting conditions, as well as on the virulence of the organism and the size of the inoculum. This review examines evolving concepts of sepsis and discusses new and potential therapies. Recent clinical advances include therapy with activated protein C, stringent control of… 
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References

SHOWING 1-10 OF 124 REFERENCES
Strategies for the treatment of sepsis.
TLDR
A remarkable number of clinical trials have been performed in the past decade to evaluate drugs for the treatment of sepsis, and the evidence for widespread beliefs that endotoxin contributes to the morbidity and mortality caused by infection with gram-negative bacteria is found.
Pathogenetic mechanisms of septic shock.
  • J. Parrillo
  • Medicine
    The New England journal of medicine
  • 1993
One of the most frequent and serious problems confronting clinicians is the management of a serious infection and the systemic response to infection, a syndrome termed sepsis. When this syndrome…
Selected Treatment Strategies for Septic Shock Based on Proposed Mechanisms of Pathogenesis
TLDR
The discussants in this conference review several of these new therapies that are directed at different elements of the inflammatory cascade, including a bacterial toxin (endotoxin), host proteins that mediate the inflammatory response (TNF and IL-1), an inflammatory cell (the neutrophil), and a low-molecular-weight messenger (nitric oxide) that causes hypotension.
The enigma of sepsis.
TLDR
The search for effective therapeutic interventions, hurdles in translational sepsis research, and new therapies in development in current clinical trials are discussed.
Apoptosis in sepsis: a new target for therapeutic exploration.
TLDR
Although clinical trials with anti-apoptotic agents remain distant due in large part to technical difficulties associated with their administration and tissue targeting, inhibition of lymphocyte apoptosis represents an attractive therapeutic target for the septic patient.
ANIMAL MODELS OF SEPSIS AND SHOCK: A REVIEW AND LESSONS LEARNED
TLDR
The goal of this review article is to review the advantages and disadvantages of commonly used sepsis and shock models in light of lessons learned from these clinical trials.
Laboratory models of sepsis and septic shock.
Ethyl Pyruvate Protects against Lethal Systemic Inflammation by Preventing HMGB1 Release
TLDR
The recent identification of cytokines released after the acute phase provides an alternative target for delayed treatments that can be initiated after the onset of the clinical signs of sepsis, and the potential of the recently discovered novel therapeutic targets is reviewed.
Corticosteroids for septic shock
  • D. Annane
  • Medicine, Biology
    Critical care medicine
  • 2001
TLDR
Current evidence that the therapeutic interest of replacement therapy with corticosteroids increases suggests that low doses of hydrocortisone should be offered to patients with catecholamine-dependent septic shock.
A Randomized Controlled Trial of Filgrastim as an Adjunct to Antibiotics for Treatment of Hospitalized Patients with Community-Acquired Pneumonia
TLDR
It was hypothesized that stimulation of neutrophil production and function with Filgrastim would improve the outcome of hospitalized patients with community-acquired pneumonia and appeared to reduce serious complications.
...
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