Management of septic shock: present and future
Article Abstract:
Sepsis, sometimes complicated by shock, is the disease state that arises from serious infection that has travelled throughout the body through the bloodstream. The incidence of sepsis is rising due to the use of invasive devices, such as indwelling catheters in the bladder and large intravenous lines, the increased use of immune suppressing medications, and the longer lifespan of people who are prone to developing sepsis because of underlying disease. Sepsis begins when a microorganism, usually bacterial, gains entry into the body and begins multiplying. Either the organisms themselves or some of the substances they produce set off what is called the sepsis cascade, a series of reactions in the body that release mediators. These are compounds that act on the blood vessels, the heart, and other organs. Their actions include depressing the heart's pumping function, low blood pressure, decreased blood supply to vital organs, and, frequently, death. The treatment of sepsis begins with the administration of antibiotics, and continues with careful monitoring, generally only available in an intensive care unit. In recent months, treatments to inhibit the mediators of the cascade have become available. One of these very new mediator-inhibitors is known as a monoclonal antibody, which has been shown to cause a dramatic reduction in the mortality from sepsis in a certain group of patients suffering a particular type of infection. The success of this monoclonal antibody therapy demonstrates the need to find other sepsis mediator-inhibitors to interrupt the sepsis cascade at as many points as possible. Innovations in this area should help reduce patient mortality from sepsis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
High-dose ifosfamide is associated with severe, reversible cardiac dysfunction
Article Abstract:
Treatment with high doses of ifosfamide may cause congestive heart failure in some patients. Ifosfamide is a drug used to treat patients suffering from cancer or advanced lymphoma who undergo bone marrow transplantation. Among 52 patients with cancer or advanced lymphoma who were treated with increasing doses of ifosfamide in combination with other anti-cancer drugs, nine (17%) developed congestive heart failure. Patients developed congestive heart failure an average of 12 days after starting treatment with ifosfamide. Eight patients were admitted to the intensive care unit to undergo treatment for severe congestive heart failure. Symptoms developed by the patients before admission to the hospital included shortness of breath, rapid heart beat, weight gain and collection of fluid in the lungs. One patient died from complications associated with the development of congestive heart failure.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1993
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects. Periconceptional folic acid exposure and risk of occurrent neural tube defects
- Abstracts: Does obstetric ethics have any role in the obstetrician's response to the abortion controversy? part 2 Argument-based medical ethics: A formal for critically appraising the normative medical ethics literature
- Abstracts: Prevalence and determinants of estrogen replacement therapy in elderly women. part 2 Effects of thiazide diuretic therapy on bone mass, fractures, and falls
- Abstracts: Surgical procedures for bleeding esophagogastric varices when sclerotherapy fails: a prospective study. Selective variceal decompression and its role relative to other therapies
- Abstracts: Uptake and degradation of soluble aggregates of IgG by monocytes of patients with rheumatoid arthritis: relation to disease activity. part 2