Sepsis (eBook)

Preface 5
Contents 7
Contributors 9
Chapter 1 Macrolides in Severe Community-Acquired Pneumonia and Sepsis 12
1.1 Introduction 12
1.2 Immunomodulation in Sepsis 14
1.3 Macrolides as Immunomodulators 15
1.4 Laboratory Evidence 15
1.5 Experimental Evidence 16
1.6 Clinical Evidence 17
1.7 Conclusion 22
Chapter 2 The Potential Role of Statins in Severe Sepsis 30
2.1 Introduction 30
2.2 Statins 31
2.3 Observational Studies 32
2.4 Conclusion 35
Chapter 3 The Genetics of Sepsis: The Promise, the Progress and the Pitfalls 40
3.1 Introduction 40
3.2 Basic Genetic Terminology 41
3.3 Studies of Genetic Influence on the Inflammatory Response 42
3.4 Problems with Genetic Studies in Sepsis 48
3.5 Summary 49
Chapter 4 Corticoids in Severe Pneumonia 56
4.1 Introduction 56
4.2 Inflammatory Response Associated with Pneumonia 56
4.3 Glucocorticoids and Inflammatory Response 57
4.4 Role of Glucocorticoids in Severe Pneumonia 58
4.5 Pending Questions 60
4.6 Conclusions 61
Chapter 5 Aging, Inflammation, and Pneumococcal Disease 64
5.1 Introduction 64
5.2 Bacterial Pathogenesis 66
5.3 Inflammation Increases Susceptibility to IPD 69
5.4 Age-Related Defects in Immune Function 73
5.5 Anti-inflammatory Drugs as Therapeutics 74
5.6 Summary 75
Chapter 6 Nonspecific Removal of Sepsis Mediators 80
6.1 Introduction 80
6.2 Why a Nonspecific Approach? 81
6.3 Continuous Renal Replacement Therapy 82
6.4 CRRT and Cytokine Removal 83
6.5 CRRT in Sepsis 85
6.6 Ultrafiltrate Dose 85
6.7 When CRRT Should Begin? 87
6.8 Membrane and Pore Size 88
6.9 Other Therapies 89
6.10 Plasmapheresis 90
6.11 Adsorption Techniques 90
6.12 Coupled Plasma Filtration Adsorption 90
6.13 Conclusion 91
Chapter 7 Optimal Antibiotic Use in Severe Community-Acquired Pneumonia 96
7.1 Introduction 96
7.2 Antibiotic Therapy: New Concepts 97
7.3 Management of SCAP 98
Chapter 8 Dose Adjustment and Pharmacodynamic Considerations for Antibiotics in Severe Sepsis and Septic Shock 108
8.1 Introduction 108
8.2 Applied Clinical Pharmacology 108
8.3 Kill Characteristics of Different Antibiotic Classes 110
8.4 Sepsis 115
8.5 Duration of Antibiotic Therapy for Critically Ill Patients with Sepsis 119
8.6 Implications of Under-dosing in Sepsis 119
8.7 Antibiotic Classes 120
8.8 PK/PD Modelling 132
8.9 Conclusion 133
References 133
Index 148