Läkartidningen
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Comparative Study
[End-of-life decision making in six European countries].
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Comment Review
[Septic shock--a condition with great potential for improvement. Management and therapy].
There is a recent focus upon treatment of septic shock, related to the publication of a number of interesting studies during the last two years. These studies indicate that patient outcome can be improved, provided care is organized so as to optimize and expedite initial treatment of the patient in septic shock. ⋯ These "new" therapies are presented in a total context with a temporal perspective. It is suggested that emergency sepsis teams be instituted at hospitals.
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Human recombinant activated protein C (Xigris) represents a new concept in adjuvant therapy for patients with severe sepsis. In the large randomized controlled trial on which the registration is based, 28 day mortality was significantly reduced by 6.1% from 30.8% in the placebo group to 24.7% in the treatment group. ⋯ Until further data becomes available from ongoing studies, we recommend that treatment be restricted to those patients for whom benefit has been shown in the clinical trial, i.e. adult patients with septic shock and at least one additional sign of organ dysfunction as defined in the study. Patients with septic organ dysfunctions with a longer duration than 24 h were not evaluated in the study.