الفهرس 
Management of septic shockOnly 14 pages are availabe for public view
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Abstract
Glucocorticoid therapy, nutritional support, and glucose control are additional issues that are important in the management of patients with severe sepsis or septic shock. Recently, continuous renal replacement therapy is a way to restore the kidney functions back in such critical situations which is accompanied with acute renal failure, fluid retention or severe sepsis by the continuous hemodiafiltration.
Enteral nutrition is important because it is generally safer and more effective than total parenteral nutrition. However, total parenteral nutrition may be required. Stress ulcer prophylaxis with the use of histamine H2–receptor antagonists may decrease the risk of gastrointestinal hemorrhage. Polyclonal intravenous immunoglobulins (IVIG) can modulate the host immune response and may improve outcomes in some patients.
Several types of therapies have proven ineffective. Antilipopolysaccharide, numerous therapies that block proinflammatory cytokines, ibuprofen, platelet-activating factor acetylhydrolase, bradykinin antagonists and other therapies have not improved survival among patients with sepsis.
There are several potentially new therapies as inhibition of tissue factor & inhibition of apoptosis. Super-antigens and mannose may be potential therapeutic targets. Interferon gamma improved macrophage function and increased survival. Lipid emulsions & anti-MIF antibodies are also potential new therapies on the way.
As a conclusion; the care of patients with septic shock is exceedingly complex. New therapies and monitoring technologies are being rapidly developed. To create an effective plan of care that integrates these new therapies and technologies, critical care team stuff must understand the underlying pathophysiology of septic shock, techniques to accurately monitor patients’ status, and the rationale for optimal treatment strategies.