1.
Crit Care
; 22(1): 215, 2018 Sep 19.
Article
in English
| MEDLINE
| ID: mdl-30231909
ABSTRACT
Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mortality. Such patients are often poorly represented in large clinical trials. Consequently, good evidence for effective treatment strategies is lacking. In this article, we describe a pragmatic, multi-faceted approach to managing patients with refractory septic shock based on our experience of toxin-mediated sepsis in a specialist referral centre. Many components of this strategy are inexpensive and widely accessible, and so may offer an opportunity to improve outcomes in these critically ill patients.
Subject(s)
Shock, Septic/classification , Shock, Septic/drug therapy , Adrenal Cortex Hormones/pharmacology , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cardiotonic Agents/pharmacology , Cardiotonic Agents/therapeutic use , Extracorporeal Membrane Oxygenation/methods , Humans , Immunoglobulins/pharmacology , Immunoglobulins/therapeutic use , Multiple Organ Failure/prevention & control , Renal Replacement Therapy/methods , Serum Albumin, Human/pharmacology , Serum Albumin, Human/therapeutic use , Simendan/pharmacology , Simendan/therapeutic use , Treatment Outcome , Vasoconstrictor Agents/pharmacology , Vasoconstrictor Agents/therapeutic use
2.
Liver Transpl
; 22(12): 1727-1733, 2016 12.
Article
in English
| MEDLINE
| ID: mdl-27600579