Tuberc Respir Dis.  2012 Jul;73(1):1-10. 10.4046/trd.2012.73.1.1.

Critical Care Paper Review 2012

• Sohn JW

• KMID: 2050669
• DOI: http://doi.org/10.4046/trd.2012.73.1.1

Abstract

Care of patients with sepsis has improved over the last decade. However, in the recent two years, there was no significant progress in the development of a new drug for critically ill patients. In January 2011, it was announced that the worldwide phase 3 randomized trial of a novel anti-Toll-like receptor-4 compound, eritoran tetrasodium, had failed to demonstrate an improvement in the mortality of patients with severe sepsis. In October 2011, Xigris (drotrecogin alfa, a recombinant activated protein C) was withdrawn from the market following the failure of its worldwide trial that had attempted to demonstrate improved outcome. These announcements were disappointing. The recent failure of 2 promising drugs to further reduce mortality suggests that new approaches are needed. A study was published showing that sepsis can be associated to a state of immunosuppression and loss of immune function in human. However, the timing, incidence, and nature of the immunosuppression remain poorly characterized, especially in humans. This emphasizes the need for a better understanding of sepsis as well as new therapeutic strategies. Many clinical experiences of the extracorporeal membrane oxygenator (ECMO) treatment for adult acute respiratory distress syndrome (ARDS) patients, which is caused by the H1N1 influenza A virus, were reported. The use of ECMO in severe respiratory failure, particularly in the treatment of adult ARDS, is occurring more commonly.

Keyword

Critical Care; Review; Extracorporeal Membrane Oxygenation; Sepsis

MeSH Terms

Adult
Critical Care
Critical Illness
Disaccharides
Extracorporeal Membrane Oxygenation
Humans
Immunosuppression
Incidence
Influenza A virus
Oxygenators, Membrane
Protein C
Recombinant Proteins
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Sepsis
Sugar Phosphates
Disaccharides
Protein C
Recombinant Proteins
Sugar Phosphates

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