The pathophysiology and treatment of sepsis

RS Hotchkiss, IE Karl - New England journal of medicine, 2003 - Mass Medical Soc
RS Hotchkiss, IE Karl
New England journal of medicine, 2003Mass Medical Soc
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 blood glucose, and early goal-directed therapy to …
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 blood glucose, and early goal-directed therapy to treat cellular oxygen deficit. Future therapies may be focused on modulating the immune response in the light of the characteristics of the specific pathogen, the genetic profile of the patient, and the duration of the disease.
The New England Journal Of Medicine