Critical care clinics
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Septic shock continues to be associated with high mortality. The systemic effects of severe infections are related to the release and activation of a myriad of mediator systems, central to which are bacterial toxins and cytokines. Therapy includes three facets--resuscitation, treatment of the underlying infection, and interventions directed at ameliorating mediator activity.
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Circulatory shock is a syndrome characterized by imbalance between oxygen supply and demand. Myriad different mediators are responsible for the systemic manifestations of shock. The therapeutic approach requires initial interventions directed at increasing oxygen delivery followed by definitive therapy for the causative process. Areas of ongoing research involve mediated-directed therapy, reperfusion injury, and immunologic interventions directed at reducing infectious complications in the survivors of circulatory shock.