Division of Critical Care Medicine, Cincinnati Children's Hospital Research Foundation, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Crit Care Clin. 2013 Apr;29(2):203-22. doi: 10.1016/j.ccc.2012.11.003. Epub 2013 Jan 3.
Sepsis remains an important challenge in pediatric critical care medicine. This review provides an appraisal of adjunctive therapies for sepsis and highlights opportunities for meeting selected challenges in the field. Future clinical studies should address long-term and functional outcomes as well as acute outcomes. Potential adjunctive therapies such as corticosteroids, hemofiltration, hemoadsorption, and plasmapheresis may have important roles, but still require formal and more rigorous testing by way of clinical trials. Finally, the design of future clinical trials should consider novel approaches for stratifying outcome risks as a means of improving the risk-to-benefit ratio of experimental therapies.
脓毒症仍然是儿科重症监护医学的一个重要挑战。这篇综述评估了脓毒症的辅助治疗方法，并强调了该领域应对选定挑战的机会。未来的临床研究应关注长期和功能结果以及急性结果。皮质类固醇、血液滤过、血液吸附和血浆置换等潜在的辅助治疗方法可能具有重要作用，但仍需要通过临床试验进行正式和更严格的测试。最后，未来临床试验的设计应考虑分层结局风险的新方法，以提高实验治疗的风险效益比。
