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Semin Respir Crit Care Med 2010; 31(1): 066-078
DOI: 10.1055/s-0029-1246290
© Thieme Medical Publishers

Controversies in the Treatment of Sepsis

Christian E. Sandrock1 , Timothy E. Albertson1 , 2
  • 1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Clinical Medicine, University of California Davis School of Medicine, Sacramento, California
  • 2VA Northern California Health System, Sacramento, California
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Publication History

Publication Date:
25 January 2010 (online)

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ABSTRACT

Sepsis is a common illness of intensive care unit patients that carries a high morbidity, mortality, and increases hospital cost. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. Many interventions, such as early appropriate antibiotic therapy and lung protective, low tidal volume ventilation are commonplace and carry little controversy in their benefit. However, other therapies still have an unclear benefit and remain controversial. This article discusses the controversial roles of intensive insulin therapy, corticosteroids, and activated protein C in the treatment of sepsis.

KEYWORDS

Sepsis - septic shock - activated protein C - insulin - glucose control - corticosteroids

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Christian E SandrockM.D. M.P.H. 

4150 V St., Ste. 3400

Sacramento, CA 95817

Email: cesandrock@ucdavis.edu

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