Critical care medicine
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Critical care medicine · Mar 2009
Randomized Controlled Trial Multicenter StudyImpact of continuous venovenous hemofiltration on organ failure during the early phase of severe sepsis: a randomized controlled trial.
The impact of continuous venovenous hemofiltration on sepsis-induced multiple organ failure severity is controversial. We sought to assess the effect of early application of hemofiltration on the degree of organ dysfunction and plasma cytokine levels in patients with severe sepsis or septic shock. ⋯ These data suggest that early application of standard continuous venovenous hemofiltration is deleterious in severe sepsis and septic shock. This study does not rule out an effect of high-volume hemofiltration (>35 mL/kg/hr) on the course of sepsis.
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Critical care medicine · Mar 2009
Randomized Controlled Trial Multicenter Study Comparative StudyInteraction of vasopressin infusion, corticosteroid treatment, and mortality of septic shock.
Vasopressin and corticosteroids are often added to support cardiovascular dysfunction in patients who have septic shock that is nonresponsive to fluid resuscitation and norepinephrine infusion. However, it is unknown whether vasopressin treatment interacts with corticosteroid treatment. ⋯ There is a statistically significant interaction between vasopressin and corticosteroids. The combination of low-dose vasopressin and corticosteroids was associated with decreased mortality and organ dysfunction compared with norepinephrine and corticosteroids.