Refractory septic shock: our pragmatic approach

Critical Care : the Official Journal of the Critical Care Forum
Prashanth NandhabalanDuncan Wyncoll

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.

References

Jan 1, 1992·Intensive Care Medicine·M A HayesJ D Watson
Sep 13, 2002·Critical Care : the Official Journal of the Critical Care Forum·Stephan M Jakob
Jun 24, 2005·Intensive Care Medicine·Marjut VarpulaVille Pettilä
Jan 11, 2008·The New England Journal of Medicine·Charles L SprungUNKNOWN CORTICUS Study Group
Jun 11, 2009·JAMA : the Journal of the American Medical Association·Djillali AnnaneG Umberto Meduri
Jul 22, 2010·Journal of Critical Care·Michael W DonninoLong Ngo
Oct 22, 2011·American Journal of Respiratory and Critical Care Medicine·Shruti B Patel, John P Kress
Mar 20, 2012·Critical Care : the Official Journal of the Critical Care Forum·Manu Shankar-HariMervyn Singer
Aug 23, 2012·Chest·Samuel M BrownAlan H Morris
Feb 4, 2014·Journal of Translational Medicine·Alpha A FowlerRamesh Natarajan
Mar 19, 2014·The New England Journal of Medicine·Pietro CaironiUNKNOWN ALBIOS Study Investigators
May 3, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jonathan R CarapetisRoss Andrews
Jul 30, 2014·Critical Care Medicine·Duane FunkUNKNOWN Cooperative Antimicrobial Therapy of Septic Shock Database Research Group
Sep 4, 2014·Critical Care : the Official Journal of the Critical Care Forum·Heleen M Oudemans-van StraatenMonique C de Waard
Nov 28, 2015·Critical Care : the Official Journal of the Critical Care Forum·Anitra C CarrRamesh Natarajan
Jan 16, 2016·Critical Care Medicine·Michael W DonninoUNKNOWN Center for Resuscitation Science Research Group
May 11, 2016·Journal of Research in Pharmacy Practice·Mohadeseh Hosseini ZabetHossein Khalili
Oct 6, 2016·The New England Journal of Medicine·Anthony C GordonDeborah Ashby
Jan 8, 2017·Journal of Pain and Symptom Management·Donald A BrandPeter Spiegler
Jan 19, 2017·Critical Care Medicine·Andrew RhodesR Phillip Dellinger
Sep 22, 2017·Journal of Critical Care·J TengM Mazer-Amirshahi
Dec 13, 2017·Critical Care : the Official Journal of the Critical Care Forum·Anitra C CarrGeoff M Shaw
Jan 20, 2018·The New England Journal of Medicine·Balasubramanian VenkateshUNKNOWN ADRENAL Trial Investigators and the Australian–New Zealand Intensive Care Society Clinical Trials Group
Mar 1, 2018·The New England Journal of Medicine·Djillali AnnaneUNKNOWN CRICS-TRIGGERSEP Network
May 24, 2018·Perfusion·Dominik J VogelNicholas Barrett

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Citations

Jan 24, 2019·Expert Review of Anti-infective Therapy·Jan J De Waele, Sofie Dhaese
May 21, 2020·European Heart Journal Supplements : Journal of the European Society of Cardiology·Fabio GuarracinoJosep Masip
Jun 30, 2019·Journal of Intensive Care Medicine·Daisuke KasugaiNorimichi Uenishi
Aug 4, 2019·Critical Care : the Official Journal of the Critical Care Forum·Daniel Taylor, Duncan Wyncoll
Apr 9, 2019·Journal of Pharmacy Practice·Pamela L Smithburger, Mona K Patel
May 4, 2021·The Journal of Surgical Research·Kathleen E SingerMichael D Goodman
Jun 29, 2021·BJA Education·A JhaA Rhodes
Aug 29, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Amit AlamJennifer L Mooney

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