Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지

Sepsis

패혈증

  • Kim, Jae Yeol (Department of Medicine, ChungAng University College of Medicine)
  • 김재열 (중앙대학교 의과대학 내과학교실)
  • Published : 2007.07.30
Download PDF
⟨ Previous Next ⟩

Abstract

현 상태에서 패혈증에서 최선의 치료는 조기, 목표지향치료, 저일호흡량을 포함한 폐 보호 기계환기, 그리고 activated protein C 등을 들 수 있으며, 코티코스테로이드 치료나 적극적인 인슐린 치료법에 대해서는 아직 치료효과가 검증되지 않은 상태이다. 전통적으로 시행되고 있는 조기에 광범위한 항생제 투여, 창상의 치료 등은 한상 강조되어야 할 치료 방법이다.

Keywords

References

  1. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342: 1301-8 https://doi.org/10.1056/NEJM200005043421801
  2. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001;345:1368-77 https://doi.org/10.1056/NEJMoa010307
  3. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definition for sepsis and organ failure and guidelines for the use of innovative therapies for the use of innovative therapies in sepsis. Chest 1992;101:1644-55 https://doi.org/10.1378/chest.101.6.1644
  4. Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699-709 https://doi.org/10.1056/NEJM200103083441001
  5. Van den Berghe G, Wouters P, Weeders F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001;345:1359-67 https://doi.org/10.1056/NEJMoa011300
  6. Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milangts I, et al. Intensive insulin therapy in the medical ICU. N Engl J Med 2006;354:449-61 https://doi.org/10.1056/NEJMoa052521
  7. Bernard GR, Margolis BD, Shanies HM, Ely EW, Wheeler AP, Levy H, et al. Extended evaluation of recombinant human activated protein C United States trial (ENHANCE US): a single-arm,, phase 3B, multicenter study of drotrecogin alfa (activated) in severe sepsis. Chest 2004;125: 2206-16 https://doi.org/10.1378/chest.125.6.2206
  8. The National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. Higher versus lower positive respiratory distress syndrome. N Engl J Med 2001;351:327-36
  9. Docke WD, Randow F, Syrbe U, Krausch D, Asadullah K, Reinke P, et al. Monocyte deactivation in septic patients: restoration by INF-gamma treatment. Nat Med 1997;3:678-81 https://doi.org/10.1038/nm0697-678
  10. Hotchkiss RS, Chang KC, Swanson PE, Tinsley KW, Hui JJ, Klender P, et al. Caspase inhibitors improve survival in sepsis : a critical role of the lymphocyte. Nat Immunol 2000;1:496-501 https://doi.org/10.1038/82741
  11. American College of Chest Physicians/Society of Critical Care Medicine. Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 1992;20:864-74 https://doi.org/10.1097/00003246-199206000-00025
  12. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546-54 https://doi.org/10.1056/NEJMoa022139
  13. Russell JA. Management of sepsis. N Engl J Med 2006;355:1699-713 https://doi.org/10.1056/NEJMicm055674
  14. Annane D, Bellissant E, Bollaert PE, Briegel J, Keh D, Kupfer Y. Corticosteroids for severe sepsis and septic shock: a systematic review and meta- analysis. BMJ 2004;329:480