Clinical Trials for the Treatment of Sepsis

ISBN-13: 9783642792267 / Angielski / Miękka / 2011 / 406 str.

W. J. Sibbald; Jean-Louis Vincent

Opis

The incidence of sepsis is increasing as new medical and surgical technologies are applied to an increasingly aging patient population. The treatment of sepsis emphasizes strategies to avoid multiple organ dysfunction, with particular attention to establishing source control, and then modifies the host's response to the excessive inflammatory response which characterizes sepsis. This book is a comprehensive review by internationally recognized experts of the epidemiology, monitoring and treatment of sepsis. Using an "evidence-based" approach, it comprises an extensive review of the literature on sepsis, provides up-to-date recommendations for monitoring and treating sepsis patients, and concludes with explicit recommendations for the design and monitoring of future clinical trials.

Spis treści

Epidemiology of Sepsis.- The Systemic Inflammatory Response Syndrome (SIRS).- The “At Risk” Patient Population.- Outcome and Prognostic Factors in Bacteremic Sepsis.- ARDS and Sepsis: Resemblances and Differences.- Monitoring the Treatment of Sepsis.- Microbiological Requirements for Studies of Sepsis.- Measurement of Inflammatory Mediators in Clinical Sepsis.- Whole Body and Organ Measures of 02 Availability.- Multiple Organ Dysfunction Syndrome (MODS).- Monitoring Illness Severity.- What Determines Prognosis in Sepsis?.- SAPS II and MPM II Models for Early Severe Sepsis.- Clinical Management of Sepsis.- Fluid Therapy in Septic Shock.- Role of RBC Transfusion Therapy in Sepsis.- Vasoactive Drug Therapy in Sepsis.- Evidence-Based Analysis of Nutrition Support in Sepsis.- Investigational Therapy of Sepsis.- Anti-Endotoxin Therapy.- Critical Reappraisal of Steroids and Other Anti-Inflammatory Agents.- Investigational Therapy of Sepsis: Anti-TNF, IL-1ra, Anti-PAF and G-CSF.- Sepsis and Acute Lung Injury.- Increasing Oxygen Delivery in Sepsis.- Designing the Optimum Clinical Trial for the Treatment of Sepsis.- Critical Evaluation of the Design and Conduct of Previous Clinical Trials in Sepsis.- Evaluation of the Adequacy of Source Control.- Statistical Considerations for the Design of the Optimal Clinical Trial.- The Monitoring and Reporting of Clinical Trials.- Economic Evaluation in the Critical Care Literature.- Ethical Issues in Clinical Trials.