Revue médicale de Liège
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Revue médicale de Liège · May 2007
Review[Recent therapeutic advances in intensive care: update on severe sepsis/septic shock and on pulmonary embolism].
Septic shock and pulmonary embolism remain leading causes of death in intensive care units. Recent therapeutic advances have contributed to decrease the mortality rate of septic shock. Among these, early goal directed hemodynamic therapy, corticoid and activated protein C are the most efficient. ⋯ Its main objective is to decrease mortality rate of sepsis by 25% in the next five years. The diagnostic strategy of pulmonary embolism has been improved by the use of validated algorithms using clinical probability, d-dimers, angioscan and venous doppler. The growing use of low molecular weight heparin has also improved and facilitated the therapeutic management of pulmonary embolism while indication of fibrinolysis in presence of right ventricular dysfunction, but without shock, remains controversial.