Two recent trials have highlighted that our strategies to restore tissue perfusion early and decrease mortality in patients with sepsis are varied and evidence for an effective therapy to reduce the incidence of kidney injury is lacking. However, newly reported data suggest an overall improved standard of care for patients.
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References
Caironi, P. et al. Albumin replacement in patients with severe sepsis or septic shock. N. Engl. J. Med. 370, 1412–1421 (2014).
Asfar, P. et al. High versus low blood-pressure target in patients with septic shock. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1312173.
Kaukonen, K. M., Bailey, M., Suzuki, S., Pilcher, D. & Bellomo, R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000–2012. JAMA 311, 1308–1316 (2014).
Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 317, 235–240 (1998).
Finfer, S. et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N. Engl. J. Med. 350, 2247–2256 (2004).
Delaney, A. P., Dan, A., McCaffrey, J. & Finfer, S. The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit. Care Med. 39, 386–391 (2011).
Parving, H. P. & Gyntelberg, F. Transcapillary escape rate of albumin and plasma volume in essential hypertension. Circ. Res. 32, 643–651 (1973).
Fleck, A. et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1, 781–784 (1985).
Kelleher, S. P., Robinette, J. B. & Conger, J. D. Sympathetic nervous system in the loss of autoregulation in acute renal failure. Am. J. Physiol. 246, F379–F386 (1984).
Annane, D. et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 370, 676–684 (2007).
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Mohandas, R., Ejaz, A. A silver lining in the quest for improved survival in sepsis. Nat Rev Nephrol 10, 302–304 (2014). https://doi.org/10.1038/nrneph.2014.77
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DOI: https://doi.org/10.1038/nrneph.2014.77