engleski

CAN WE DECREASE MORTALITY RATES IN SEPTIC PATIENTS

Sepsis still presents an important medical problem. Severe sepsis and septic shock have high mortality rates. In the last five years significant new conclusions have been reached regarding factors that influence mortality rates in septic patients as well as changes in certain therapeutic approaches. Correct, early initiated appropriate antimicrobial therapy still presents the most significant factor that influences patient survival. However, numerous other factors contribute also to improved treatment outcome. Apart from the regulation of hemodynamics and treatment of shock, today more attention is paid to regulation of glucose levels in blood, which should not be higher than 8 mmol/L. In patients with protracted shock, substitution doses of hydrocortisone are administered (200-300 mg daily). Although there are still some misconceptions about anticoagulant therapy (antithrombin III and activated C protein), in some patients the administration of these drugs reduced mortality rates. Substitution of renal function with a continuous venous-venous hemodiafiltration significantly improved the treatment of septic patients. A great deal of attention is also paid to nutrition of septic patients, however its impact on patient survival has yet not been entirely proved.

sepsis; steroids

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