Optimizing Our Approach to Treating and Preventing Sepsis

During the last 20 years, great efforts have been directed toward developing "magic bullets" to reverse sepsis, and 1 such agent, activated protein kinase C, is now approved by the FDA. However, 2 new reports indicate that intensive management of hemodynamic and metabolic parameters in critically ill patients can also provide significant benefit.

Rivers and colleagues undertook a randomized trial of early intensive hemodynamic interventions for managing patients presenting to an emergency department with severe sepsis or septic shock. Patients underwent arterial and central venous catheterization, and before admission to an intensive care unit (ICU), they were randomized either to 6 hours of standard care (controls) or to goal-directed thera…