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 The first and only activated protein C drug, drotrecogin alfa (Xigris), was voluntarily withdrawn in October of 2011 after it failed to show a benefit in patients with septic shock, including the more severe disease subgroups.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
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