Colloids for Sepsis: Effectiveness and Cost Issues

• Type of Material: Book Chapter
• Authors: A Farrugia, University of Western Australia; Gregory Martin, Emory University; M Bult, Plasma Protein Therapeutics Association
• Language: English
• Date: 2013-04-08
• Publisher: Emory University Libraries
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Springer-Verlag Berlin Heidelberg 2013
• Final Published Version (URL): http://dx.doi.org/10.1007/978-3-642-35109-9_41
• Title of Journal or Parent Work: Annual Update in Intensive Care and Emergency Medicine 2013
• Start Page: 515
• End Page: 526
• Place of Publication or Presentation: Springer, Berlin, Heidelberg
• Keywords: Sepsis; Medical; Colloid; Critical Care
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, General

Abstract

Severe sepsis, defined as acute organ dysfunction secondary to infection, and septic shock, defined as severe sepsis plus hypotension not reversed with fluid resuscitation, originate in the systemic inflammatory response following infection and lead to cardiovascular and organ dysfunction. Sepsis is a major cause of hospital mortality and a considerable economic burden [1]. Resuscitation in sepsis is initially based on goal-directed fluid therapy. This modality remains controversial [2] and a recent randomized trial indicated that bolus fluid therapy in a large population of children with sepsis in a resource-challenged environment [3] increased mortality irrespective of the type of fluid. Nevertheless, this remains an active area of clinical investigation, as evidenced by the large number of registered relevant trials on www.clinicaltrials.gov. The timing, rather than the type, of fluid therapy has been proposed as being crucial.