Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Clinical Medicine, University of California Davis School of Medicine, Sacramento, CA95817, USA.
Semin Respir Crit Care Med. 2010 Feb;31(1):66-78. doi: 10.1055/s-0029-1246290. Epub 2010 Jan 25.
Sepsis is a common illness of intensive care unit patients that carries a high morbidity, mortality, and increases hospital cost. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. Many interventions, such as early appropriate antibiotic therapy and lung protective, low tidal volume ventilation are commonplace and carry little controversy in their benefit. However, other therapies still have an unclear benefit and remain controversial. This article discusses the controversial roles of intensive insulin therapy, corticosteroids, and activated protein C in the treatment of sepsis.
脓毒症是重症监护病房患者常见的疾病，具有较高的发病率、死亡率，并增加了医院的成本。尽管与其他危重病相比，脓毒症的死亡率仍然很高，但由于一些辅助治疗和集中护理计划或指南，死亡率在过去几十年中有所下降。许多干预措施，如早期适当的抗生素治疗和肺保护性、小潮气量通气已经很常见，并且在其获益方面几乎没有争议。然而，其他治疗方法的获益仍不明确，存在争议。本文讨论了强化胰岛素治疗、皮质类固醇和活化蛋白 C 在脓毒症治疗中的有争议的作用。
