Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T09:55:02.991Z Has data issue: false hasContentIssue false
  • English
  • Français

Lignes directrices de l’Association canadienne des médecins d’urgence sur le sepsis : la prise en charge optimale du sepsis grave dans les départements d’urgence canadiens

Published online by Cambridge University Press:  21 May 2015

Robert S. Green ,
Dennis Djogovic ,
Sara Gray ,
Daniel Howes ,
Peter G. Brindley ,
Robert Stenstrom ,
Edward Patterson ,
David Easton ,
Jonathan S. Davidow  and
au nom du comité C4 (pour CAEP Critical Care Interest Group)
Robert S. Green*
Affiliation:
département de médecine d'urgence, Université Dalhousie, Halifax, N.-É.,
Dennis Djogovic
Affiliation:
département de l'urgence de l'Université de l'Alberta, Edmonton, Alb.
Sara Gray
Affiliation:
département de médecine d'urgence de l'Université de Toronto et de médecine d'urgence et de soins intensifs de l'Hôpital St. Michael de Toronto, Ont.
Daniel Howes
Affiliation:
Médecine d'urgence et soins critiques, Université Queen's et département de médecine d'urgence, Hôpital Général de Kingston, KingstonOnt.
Peter G. Brindley
Affiliation:
département de l'urgence de l'Université de l'Alberta, Edmonton, Alb.
Robert Stenstrom
Affiliation:
Providence Health Care et département de médecine d'urgence de l'Hôpital St. Paul, Vancouver, C.-B.
Edward Patterson
Affiliation:
départements de médecine interne et de médecine d'urgence de la région sanitaire de Qu'Appelle à Régina et de l'Université de la Saskatchewan, Régina, Sask.
David Easton
Affiliation:
département de médecine d'urgence du Centre des sciences de la santé, Winnipeg, Man.
Jonathan S. Davidow
Affiliation:
département de l'urgence de l'Université de l'Alberta, Edmonton, Alb.
*
CAEP Critical Care Interest Group; 1278 Chemin Tower, bureau 349, édifice Bethune, Halifax N.-É. B3H 2Y9; greenrs@dal.ca

Résumé

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction:

La prise en charge optimale du sepsis grave dans les départements d'urgence a connu une évolution rapide. Le but des présentes lignes directrices est de revoir pour le bénéfice des médecins d'urgence canadiens les principes clés qui régissent la prise en charge du sepsis grave en se fondant sur un système de classification fondé sur des preuves.

Méthodes:

Ce sont les membres du comité de l'ACMU pour les soins critiques, ou comité C4 (pour CAEP Critical Care Interest Group) qui ont déterminé les secteurs clés de la prise en charge des patients atteints de sepsis. Chaque membre du C4 avait pour tâche de répondre à une question qui lui avait été assignée après avoir fait un survol de la littérature établie selon le système de classification Oxford, après quoi, chaque secteur faisait l'objet d'une seconde révision par un autre membre du C4. D'autres experts de l'extérieur ont procédé à un troisième examen et les modifications ont été déterminées par voie de consensus. La classification reposait sur des publications révisées par des pairs uniquement, et là où les preuves étaient insuffisantes pour répondre à une question importante, le groupe a proposé un «point pratique».

Résultats:

Le projet a débuté en 2005 et a pris fin en décembre 2007. Les secteurs clés qui ont été passés en revue incluent la définition du terme sepsis, l'utilisation des interventions effractives, la réanimation liquidienne, l'utilisation d'agents vasopresseurs/inotropes, l'importance des prélèvements pour culture aux départements d'urgence, l'antibiothérapie et le contrôle des sources. Parmi les autres secteurs examinés, mentionnons l'utilisation des corticostéroïdes, la protéine C activée, les transfusions et la ventilation mécanique.

Conclusion:

La prise en charge précoce du sepsis dans les départements d'urgence est extrêmement importante pour améliorer le pronostic des patients. L'énoncé de position du C4 sur le sepsis fournit un cadre de travail afin d'améliorer les soins prodigués à cette population de patients dans les départements d'urgence.

Keywords

sepsissepsis gravechoc septiquemédecine d'urgencelignes directricesréanimation
Type
Mise à jour de l’ACMU • CAEP Update
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 6 , November 2008 , pp. 553 - 571
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

References

Références

1.Phillips, B, Ball, C, Sackett, D, et coll.Oxford Centre for Evidence-Based Medicine levels of evidence (mai 2001). Consulté en mars 2008, http://www.cebm.net/levels_of_evidence.asp.Google Scholar
2.Strehlow, MC, Emond, SD, Shapiro, NI, et coll.National study of emergency department visits for sepsis, 1992 to 2001. Ann Emerg Med 2006;48:326–31, 331.e1-3.CrossRefGoogle ScholarPubMed
3.Martin, GS, Mannino, DM, Eaton, S, et coll.The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;17;348:1546–54.CrossRefGoogle Scholar
4.Angus, DC, Linde-Zwirble, WT, Lidicker, Jet coll.Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001;29:1303–10.Google Scholar
5.Lambe, S, Washington, DL, Fink, A, et coll.Trends in the use and capacity of California’s emergency departments, 1990–1999. Ann Emerg Med 2002;39:389–96.CrossRefGoogle ScholarPubMed
6.Meggs, WJ, Czaplijski, T, Benson, N. Trends in emergency department utilization, 1988–1997. Acad Emerg Med. 1999;6:1030–5.CrossRefGoogle ScholarPubMed
7.Parkhe, M, Myles, PS, Leach, DSet coll.Outcome of emergency department patients with delayed admission to an intensive care unit. Emerg Med (Fremantle) 2002;14:50–7.Google Scholar
8.Nelson, M, Waldrop, RD, Jones, J, et coll.Critical care provided in an urban emergency department. Am J Emerg Med 1998;16:56–9.Google Scholar
9.Varon, J, Fromm, RE Jr, Levine, RL. Emergency department procedures and length of stay for critically ill medical patients. Ann Emerg Med 1994;23:546–9.CrossRefGoogle ScholarPubMed
10.Svenson, J, Besinger, B, Stapczynski, JS. Critical care of medical and surgical patients in the ED: length of stay and initiation of intensive care procedures. Am J Emerg Med 1997;15:654–7.Google Scholar
11.Sampalis, JS, Denis, R, Lavoie, A, et coll.Trauma care regionalization: a process-outcome evaluation. J Trauma 1999;46:565,79; discussion 579–81.CrossRefGoogle ScholarPubMed
12.Rivers, E, Nguyen, B, Havstad, S, et coll.Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001;345:1368–77.CrossRefGoogle Scholar
13.Cannon, CP, Gibson, CM, Lambrew, CT, et coll.Relationship of symptom-onset-to-balloon time and door-to-balloon time with mortality in patients undergoing angioplasty for acute myocardial infarction. JAMA 2000;283:2941–7.CrossRefGoogle ScholarPubMed
14.Tissue plasminogen activator for acute ischemic stroke. the national institute of neurological disorders and stroke rt-PA stroke study group. N Engl J Med 1995;333:1581–7.Google Scholar
15.Bernard, GR, Vincent, JL, Laterre, PF, et coll.Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699–709.Google Scholar
16.Annane, D, Sebille, V, Charpentier, C, et coll.Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 2002;288:862–71.Google Scholar
17.van den, BG, Wouters, P, Weekers, F, et coll.Intensive insulin therapy in the critically ill patients. N Engl J Med 2001;345:1359–67.CrossRefGoogle Scholar
18.Bochud, PY, Bonten, M, Marchetti, O, et coll.Antimicrobial therapy for patients with severe sepsis and septic shock: an evidence-based review. Crit Care Med 2004;32:S495–512.CrossRefGoogle ScholarPubMed
19.Garnacho-Montero, J, Garcia-Garmendia, JL, Barrero-Almodovar, A, et coll.Impact of adequate empirical antibiotic therapy on the outcome of patients admitted to the intensive care unit with sepsis. Crit Care Med 2003;31:2742–51.Google Scholar
20.Leibovici, L, Shraga, I, Drucker, M, et coll.The benefit of appropriate empirical antibiotic treatment in patients with bloodstream infection. J Intern Med 1998;244:379–86.Google Scholar
21.Leone, M, Bourgoin, A, Cambon, S, et coll.Empirical antimicrobial therapy of septic shock patients: Adequacy and impact on the outcome. Crit Care Med 2003;31:462–7.Google Scholar
22.Levy, MM, Fink, MP, Marshall, JC, et coll.2001 SCCM/ES-ICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250–6.Google Scholar
23.Hotchkiss, RS, Karl, IE. The pathophysiology and treatment of sepsis. N Engl J Med 2003;348:138–50.Google Scholar
24.Rivers, EP, McIntyre, L, Morro, DC, et coll.Early and innovative interventions for severe sepsis and septic shock: taking advantage of a window of opportunity. CMAJ 2005;173:1054–65.Google Scholar
25.Bone, RC, Balk, RA, Cerra, FB, et coll.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644–55.Google Scholar
26.Rivers, E. The outcome of patients presenting to the emergency department with severe sepsis or septic shock. Crit Care 2006;10:154.CrossRefGoogle ScholarPubMed
27.Hebert, PC, Drummond, AJ, Singer, J, et coll.A simple multiple system organ failure scoring system predicts mortality of patients who have sepsis syndrome. Chest 1993;104:230–5.CrossRefGoogle ScholarPubMed
28.Nguyen, HB, Rivers, EP, Knoblich, BP, et coll.Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med 2004;32:1637–12.Google Scholar
29.Pinsky, MR. Cardiovascular effects of ventilatory support and withdrawal. Anesth Analg 1994;79:567–76.Google Scholar
30.Sugerman, HJ, Diaco, JF, Pollock, TW, et coll.Physiologic management of septicemic shock in man. Surg Forum 1971;22:3–5.Google Scholar
31.Turnaoglu, S, Tugrul, M, Camci, E, et coll.Clinical applicability of the substitution of mixed venous oxygen saturation with central venous oxygen saturation. J Cardiothorac Vasc Anesth 2001;15:574–9.Google Scholar
32.Practice parameters for hemodynamic support of sepsis in adult patients in sepsis. Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med 1999;27:639–60.Google Scholar
33.Rackow, EC, Falk, JL, Fein, IA, et coll.Fluid resuscitation in circulatory shock: A comparison of the cardiorespiratory effects of albumin, hetastarch, and saline solutions in patients with hypovolemic and septic shock. Crit Care Med 1983;11:839–50.Google Scholar
34.Finfer, S, Norton, R, Bellomo, R, et coll.The SAFE study: Saline vs. albumin for fluid resuscitation in the critically ill. Vox Sang 2004;07(Suppl 2):123–31.Google Scholar
35.Bunn, F, Alderson, P, Hawkins, V. Colloid solutions for fluid resuscitation. Cochrane Database Syst Rev 2003; (1):CD001319.Google Scholar
36.Roberts, I, Alderson, P, Bunn, F, et coll.Colloids versus crystalloids for fluid resuscitation in critically ill patients (Revue systématique Cochrane). Bibliothèque Cochrane 2004; (4):CD000567.Google Scholar
37.Alderson, P, Bunn, F, Lefebvre, C, et coll.Human albumin solution for resuscitation and volume expansion in critically ill patients. Base de données des revues systématiques Cochrane 2004;(4):CD001208.Google Scholar
38.Upadhyay, M, Singhi, S, Murlidharan, J, et coll.Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock. Indian Pediatr 2005 ;42:223–31.Google Scholar
39.Vincent, JL, Gerlach, H. Fluid resuscitation in severe sepsis and septic shock: An evidence-based review. Crit Care Med 2004; 32:S451-4.Google Scholar
40.Brunkhorst, FM, Engel, C, Bloos, F, et coll.Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008;358:125–39.CrossRefGoogle ScholarPubMed
41.Holmes, CL. Vasoactive drugs in the intensive care unit. Curr Opin Crit Care 2005;11:413–7.Google Scholar
42.Holmes, CL, Walley, KR. The evaluation and management of shock. Clin Chest Med 2003;24:775–89.CrossRefGoogle ScholarPubMed
43.Nguyen, HB, Rivers, EP, Abrahamian, FM, et coll.Emergency Department Sepsis Education Program and Strategies to Improve Survival (ED-SEPSIS) Working Group. Severe sepsis and septic shock: Review of the literature and emergency department management guidelines. Ann Emerg Med 2006;48:28–54.Google Scholar
44.Dellinger, RP, Carlet, JM, Masur, H, et coll.Surviving sepsis campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004;32:858–73.Google Scholar
45.Kuhl, DA. Current strategies for managing the patient with sepsis. Am J Health Syst Pharm 2002;02/15(Suppl 1):S9-13.Google Scholar
46.Hollenberg, SM, Ahrens, TS, Annane, D, et coll.Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med 2004;32:1928–48.CrossRefGoogle ScholarPubMed
47.De Backer, D, Creteur, J, Silva, E, et coll.Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: Which is best? Crit Care Med 2003;31:1659–67.CrossRefGoogle ScholarPubMed
48.Martin, C, Viviand, X, Leone, M, et coll.Effect of norepinephrine on the outcome of septic shock. Crit Care Med 2000;28:2758–65.Google Scholar
49.Martin, C, Papazian, L, Perrin, G, et coll.Norepinephrine or dopamine for the treatment of hyperdynamic septic shock? Chest 1993;103:1826–31.CrossRefGoogle ScholarPubMed
50.Marik, PE, Mohedin, M. The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis. JAMA 1994;272:1354–7.Google Scholar
51.Redl-Wenzl, EM, Armbruster, C, Edelmann, G, et coll.The effects of norepinephrine on hemodynamics and renal function in severe septic shock states. Intensive Care Med 1993;19:151–4.CrossRefGoogle ScholarPubMed
52.Levy, B, Bollaert, PE, Charpentier, C, et coll.Comparison of nor-epinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: A prospective, randomized study. Intensive Care Med 1997;23:282–7.Google Scholar
53.Desjars, P, Pinaud, M, Potel, G, et coll.A reappraisal of norepinephrine therapy in human septic shock. Crit Care Med 1987;15:134–7.Google Scholar
54.Meadows, D, Edwards, JD, Wilkins, RG, et coll.Reversal of intractable septic shock with norepinephrine therapy. Crit Care Med 1988;16:663–6.Google Scholar
55.Desjars, P, Pinaud, M, Bugnon, D, et coll.Norepinephrine therapy has no deleterious renal effects in human septic shock. Crit Care Med 1989;17:426–9.Google Scholar
56.Hesselvik, JF, Brodin, B. Low dose norepinephrine in patients with septic shock and oliguria: effects on afterload, urine flow, and oxygen transport. Crit Care Med 1989;17:179–80.Google Scholar
57.Marin, C, Eon, B, Saux, P, et coll.Renal effects of norepinephrine used to treat septic shock patients. Crit Care Med 1990;18:282–5.Google Scholar
58.Bellomo, R, Chapman, M, Finfer, S, et coll.Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet 2000;356: 2139–43.Google Scholar
59.Kellum, JA, Decker, M. Use of dopamine in acute renal failure: a meta-analysis. Crit Care Med 2001;29:1526–31.Google Scholar
60.Olson, D, Pohlman, A, Hall, JB. Administration of low-dose dopamine to nonoliguric patients with sepsis syndrome does not raise intramucosal gastric pH nor improve creatinine clearance. Am J Respir Crit Care Med 1996;154:1664–70.CrossRefGoogle Scholar
61.Patel, BM, Chittock, DR, Russell, JA, et coll.Beneficial effects of short-term vasopressin infusion during severe septic shock. Anesthesiology 2002;96:576–82.Google Scholar
62.Malay, MB, Ashton, RC Jr, Landry, DW, et coll.Low-dose vasopressin in the treatment of vasodilatory septic shock. J Trauma 1999;47:699–703.Google Scholar
63.Holmes, CL, Walley, KR, Chittock, DR, et coll.The effects of vasopressin on hemodynamics and renal function in severe septic shock: a case series. Intensive Care Med 2001;27:1416–21.CrossRefGoogle ScholarPubMed
64.Dufresne, RG Jr. Skin necrosis from intravenously infused materials. Cutis 1987;39:197–8.Google Scholar
65.Greenwald, RA, Rheingold, OJ, Chiprut, RO, et coll.Local gangrene: A complication of peripheral pitressin therapy for bleeding esophageal varices. Gastroenterology 1978;74:744–6.CrossRefGoogle ScholarPubMed
66.Kahn, JM, Kress, JP, Hall, JB. Skin necrosis after extravasation of low-dose vasopressin administered for septic shock. Crit Care Med 2002;30:1899–901.Google Scholar
67.Korenberg, RJ, Landau-Price, D, Penneys, NS. Vasopressin-induced bullous disease and cutaneous necrosis. J Am Acad Dermatol 1986;15:393–8.Google Scholar
68.Rudis, MI, Basha, MA, Zarowitz, BJ. Is it time to reposition vasopressors and inotropes in sepsis? Crit Care Med 1996;24:525–37.Google Scholar
69.Cohen, J, Brun-Buisson, C, Torres, A, et coll.Diagnosis of infection in sepsis: An evidence-based review. Crit Care Med 2004;32:S466-94.Google Scholar
70.Smith-Elekes, S, Weinstein, MP. Blood cultures. Infect Dis Clin North Am 1993;7:221–34.CrossRefGoogle ScholarPubMed
71.Reimer, LG, Wilson, ML, Weinstein, MP. Update on detection of bacteremia and fungemia. Clin Microbiol Rev 1997;10:444–65.CrossRefGoogle ScholarPubMed
72.Wilson, ML. General principles of specimen collection and transport. Clin Infect Dis 1996;22:766–77.Google Scholar
73.Broder, G, Weil, MH. Excess lactate: an index of reversibility of shock in human patients. Science 1964;143:1457–9.CrossRefGoogle ScholarPubMed
74.Bernardin, G, Pradier, C, Tiger, F, et coll.Blood pressure and arterial lactate level are early indicators of short-term survival in human septic shock. Intensive Care Med 1996 ;22:17–25.Google Scholar
75.Shapiro, NI, Howell, MD, Talmor, D, et coll.Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 2005;45:524–8.Google Scholar
76.Trzeciak, S, Dellinger, RP, Chansky, ME, et coll.Serum lactate as a predictor of mortality in patients with infection. Intensive Care Med 2007;33:970–7.Google Scholar
77.Aduen, J, Bernstein, WK, Khastgir, T, et coll.The use and clinical importance of a substrate-specific electrode for rapid determination of blood lactate concentrations. JAMA 1994;272: 1678–85.Google Scholar
78.Shapiro, N, Howell, MD, Bates, DW, et coll.The association of sepsis syndrome and organ dysfunction with mortality in emergency department patients with suspected infection. Ann Emerg Med 2006;48:583,90, 590.Google Scholar
79.Kumar, A, Haery, C, Paladugu, B, et coll.The duration of hypotension before the initiation of antibiotic treatment is a critical determinant of survival in a murine model of escherichia coli septic shock: association with serum lactate and inflammatory cytokine levels. J Infect Dis 2006;193:251–8.Google Scholar
80.Miner, JR, Heegaard, W, Mapes, A, et coll.Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. J Emerg Med 2001;21:387–92.Google Scholar
81.Houck, PM, Bratzler, DW, Nsa, W, et coll.Timing of antibiotic administration and outcomes for medicare patients hospitalized with community-acquired pneumonia. Arch Intern Med 2004; 164:637–44.CrossRefGoogle ScholarPubMed
82.Kumar, A, Roberts, D, Wood, KE, et coll.Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006;34:1589–96.Google Scholar
83.Bochud, PY, Glauser, MP, Calandra, T. Antibiotics in sepsis. Intensive Care Med 2001;27(Suppl 1):S33-48.CrossRefGoogle ScholarPubMed
84.Simon, D, Trenholme, G. Antibiotic selection for patients with septic shock. Crit Care Clin 2000;16:215–31.Google Scholar
85.Hughes, WT, Armstrong, D, Bodey, GP, et coll.2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730–51.Google Scholar
86.Marshall, JC, Maier, RV, Jimenez, M, et coll.Source control in the management of severe sepsis and septic shock: an evidence-based review. Crit Care Med 2004;32:S513-26.Google Scholar
87.Moss, RL, Musemeche, CA, Kosloske, AM. Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. J Pediatr Surg 1996;31:1142–6.CrossRefGoogle ScholarPubMed
88.Feistritzer, C, Wiedermann, CJ. Effects of anticoagulant strategies on activation of inflammation and coagulation. Expert Opin Biol Ther 2007;7:855–70.Google Scholar
89.Baillie, JK. Activated protein C: controversy and hope in the treatment of sepsis. Curr Opin Investig Drugs 2007;8:933–8.Google Scholar
90.Abraham, E, Laterre, PF, Garg, R, et coll.Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med 2005;353:1332–41.CrossRefGoogle Scholar
91.Bernard, GR, Margolis, BD, Shanies, HM, et coll.Extended evaluation of recombinant human activated protein C united states trial (ENHANCE US): a single-arm, phase 3B, multicenter study of drotrecogin alfa (activated) in severe sepsis. Chest 2004;125:2206–16.CrossRefGoogle Scholar
92.Yildiz, O, Doganay, M, Aygen, B, et coll.Physiological-dose steroid therapy in sepsis [ISRCTN36253388]. Crit Care 2002; 6:251–9.CrossRefGoogle ScholarPubMed
93.Briegel, J, Forst, H, Haller, M, et coll.Stress doses of hydrocortisone reverse hyperdynamic septic shock: a prospective, randomized, double-blind, single-center study. Crit Care Med 1999;27:723–32.Google Scholar
94.Bollaert, PE, Charpentier, C, Levy, B, et coll.Reversal of late septic shock with supraphysiologic doses of hydrocortisone. Crit Care Med 1998;26:645–50.Google Scholar
95.Keh, D, Boehnke, T, Weber-Cartens, S, et coll.Immunologic and hemodynamic effects of “low-dose” hydrocortisone in septic shock: a double-blind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med 2003;167:512–20.Google Scholar
96.Minneci, PC, Deans, KJ, Banks, SM, et coll.Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose. Ann Intern Med 2004;141:47–56.CrossRefGoogle ScholarPubMed
97.Annane, D, Bellissant, E, Bollaert, PE, et coll.Corticosteroids for severe sepsis and septic shock: a systematic review and meta-analysis. BMJ 2004;329:480.CrossRefGoogle ScholarPubMed
98.Annane, D, Sebille, V, Troche, G, et coll.A 3-level prognostic classification in septic shock based on cortisol levels and corti-sol response to corticotropin. JAMA 2000;283:1038–45.Google Scholar
99.Sprung, CL, Annane, D, Keh, D, et coll.Hydrocortisone therapy for patients with septic shock. N Engl J Med 2008;358:111–24.CrossRefGoogle ScholarPubMed
100Marik, PE, Zaloga, GP. Adrenal insufficiency during septic shock. Crit Care Med 2003;31:141–5.Google Scholar
101.Bourne, RS, Webber, SJ, Hutchinson, SP. Adrenal axis testing and corticosteroid replacement therapy in septic shock patients-local and national perspectives. Anaesthesia 2003;58:591–6.Google Scholar
102.Bouachour, G, Tirot, P, Gouello, JP, et coll.Adrenocortical function during septic shock. Intensive Care Med 1995;21:57–62.Google Scholar
103.Rothwell, PM, Udwadia, ZF, Lawler, PG. Cortisol response to corticotropin and survival in septic shock. Lancet 1991;337:582–3.Google Scholar
104.Goodman, S, Sprung, CL, Ziegler, D, et coll.Cortisol changes among patients with septic shock and the relationship to ICU and hospital stay. Intensive Care Med 2005;31:1362–9.Google Scholar
105.Keh, D, Sprung, CL. Use of corticosteroid therapy in patients with sepsis and septic shock: an evidence-based review. Crit Care Med 2004;32:S527-33.Google Scholar
106.Hebert, PC, Wells, G, Blajchman, MA, et coll.A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. transfusion requirements in critical care investigators, Canadian critical care trials group. N Engl J Med 1999;340:409–17.CrossRefGoogle ScholarPubMed
107.Fan, E, Needham, DM, Stewart, TE. Ventilatory management of acute lung injury and acute respiratory distress syndrome. JAMA 2005;294:2889–96.Google Scholar
108.Kallet, RH. Evidence-based management of acute lung injury and acute respiratory distress syndrome. Respir Care 2004;49:793–809.Google Scholar
109.Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The acute respiratory distress syndrome network. N Engl J Med 2000;342:1301–8.Google Scholar
110.Kollef, MH, Schuster, DP. The acute respiratory distress syndrome. N Engl J Med 1995;332:27–37.CrossRefGoogle ScholarPubMed
111.Bernard, GR, Artigas, A, Brigham, KL, et coll.The American-European consensus conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 1994;149:818–24.Google Scholar
112.Hickling, KG, Walsh, J, Henderson, S, et coll.Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 1994;22:1568–78.CrossRefGoogle ScholarPubMed
113.Amato, MB, Barbas, CS, Medeiros, DM, et coll.Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 1998;338:347–54.Google Scholar
114.Stewart, TE, Meade, MO, Cook, DJ, et coll.Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. pressure- and volume-limited ventilation strategy group. N Engl J Med 1998;338:355–61.Google Scholar
115.Bidani, A, Tzouanakis, AE, Cardenas, VJ Jr, et coll.Permissive hypercapnia in acute respiratory failure. JAMA 1994;272:957–62.CrossRefGoogle ScholarPubMed
116.Stocker, R, Neff, T, Stein, S, et coll.Prone positioning and low-volume pressure-limited ventilation improve survival in patients with severe ARDS. Chest 1997;111:1008–17.Google Scholar
117.Jolliet, P, Bulpa, P, Chevrolet, JC. Effects of the prone position on gas exchange and hemodynamics in severe acute respiratory distress syndrome. Crit Care Med 1998;26:1977–85.Google Scholar
118.Gattinoni, L, Tognoni, G, Pesenti, A, et coll.Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med 2001;345:568–73.CrossRefGoogle ScholarPubMed
119.Papazian, L, Gainnier, M, Marin, V, et coll.Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome. Crit Care Med 2005;33:2162–71.Google Scholar
120.Van den Berghe, G, Wilmer, A, Hermans, G, et coll.Intensive insulin therapy in the medical ICU. N Engl J Med 2006;354: 449–61.Google Scholar
121.Malhotra, A. Intensive insulin in intensive care. N Engl J Med 2006;354:516–8.CrossRefGoogle ScholarPubMed