Pharmacological management of sepsis
Systemic sepsis continues to be the most-difficult management problem in caring for the combat casualty. The complications of sepsis pervade all areas of injury to soldiers in the field, whether it is mechanical (missiles), thermal (burns), chemical, biological, or radiation injury. With the advent of tactical nuclear weapons, the problem of sepsis will be much higher in future wars than has previously been experienced through the world. The purpose of this chapter is a) to review the data suggesting pharmacological agents that may benefit the septic patient, and b) to emphasize the adjunctive therapies that should be explored in clinical trials. The pharmacological management of sepsis remains controversial. Most of the drugs utilized clinically treat the symptoms of the disease and are not necessarily directed at fundamental mechanisms that are known to be present in sepsis. A broad data base is emerging, indicating that NSAID should be used in human clinical trials. Prostaglandins are sensitive indicators of cellular injury and may be mediators for a number of vasoactive chemicals. Opiate antagonists and calcium channel blockers require more in-depth data; however, recent studies generate excitement for their potential use in the critically ill patient. Pharmacological effects of antibiotics, in concert with other drugs, suggest an entirely new approach to pharmacological treatment in sepsis. There is no doubt that new treatment modalities or adjunctive therapies must be utilized to alter the poor prognosis of severe sepsis that we have observed in the past 4 decades.
- Research Organization:
- Naval Medical Research Inst., Bethesda, MD (USA)
- OSTI ID:
- 5739481
- Report Number(s):
- AD-A-166012/5/XAB; NMRI-85-97
- Country of Publication:
- United States
- Language:
- English
Similar Records
Nonsteroidal Anti-Inflammatory Drug Prescriptions Are Associated With Increased Stress Fracture Diagnosis in the US Army Population
MiR-150 predicts survival in patients with sepsis and inhibits LPS-induced inflammatory factors and apoptosis by targeting NF-κB1 in human umbilical vein endothelial cells
Related Subjects
45 MILITARY TECHNOLOGY, WEAPONRY, AND NATIONAL DEFENSE
INFECTIOUS DISEASES
PHARMACOLOGY
MILITARY PERSONNEL
NUCLEAR WEAPONS
CARDIOVASCULAR AGENTS
CHEMOTHERAPY
DRUGS
MANAGEMENT
PATIENTS
POISONING
WARFARE
DISEASES
PERSONNEL
THERAPY
WEAPONS
550900* - Pathology
450202 - Explosions & Explosives- Nuclear- Weaponry- (-1989)