Treatment
Treatment primarily consists of the following.
- Volume resuscitation
- Early antibiotic administration
- Early goal directed therapy
- Rapid source identification and control.
- Support of major organ dysfunction.
Among the choices for vasopressors, norepinephrine is superior to dopamine in septic shock. Both however are still listed as first line in guidelines.
Antimediator agents may be of some limited use in severe clinical situations however are controversial:
- Low dose steroids (hydrocortisone) for 5 – 7 days led to improved outcomes.
- Recombinant activated protein C (drotrecogin alpha) in a 2011 Cochrane review was found not to decrease mortality and thus was not recommended for use. Other reviews however comment that it may be effective in those with very severe disease. The first and only activated protein C drug, drotrecogin alfa (Xigris), was voluntarily withdrawn in October of 2011 after it failed to show a benefit in patients with septic shock, including the more severe disease subgroups.
Read more about this topic: Septic Shock
Famous quotes containing the word treatment:
“[17th-century] Puritans were the first modern parents. Like many of us, they looked on their treatment of children as a test of their own self-control. Their goal was not to simply to ensure the child’s duty to the family, but to help him or her make personal, individual commitments. They were the first authors to state that children must obey God rather than parents, in case of a clear conflict.”
—C. John Sommerville (20th century)
“Our treatment of both older people and children reflects the value we place on independence and autonomy. We do our best to make our children independent from birth. We leave them all alone in rooms with the lights out and tell them, “Go to sleep by yourselves.” And the old people we respect most are the ones who will fight for their independence, who would sooner starve to death than ask for help.”
—Margaret Mead (1901–1978)
“I feel that any form of so called psychotherapy is strongly contraindicated for addicts.... The question “Why did you start using narcotics in the first place?” should never be asked. It is quite as irrelevant to treatment as it would be to ask a malarial patient why he went to a malarial area.”
—William Burroughs (b. 1914)