Abstract
Mortality from septic shock is considerable despite the advantages of cardiovascular support and antibiotic therapy. This article reviews current therapy of septic shock including immunotherapy and futher possibilities of septic shock treatment. The role of cytokines, their inhibitors and antibodies to endotoxin is mentioned. Although these treatments hold much promise for the future, careful evalution of both the benefits and complications of therapy is needed before widespread clinical use can be recommended.
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References
Andus T, Leser H-G, Gross V, Scholmerich J (1991) Akutphase-Proteine: Regulation der Synthese durch Entzündungsmediatoren und klinische Bedeutung. Intensivmedizin 28:2–10
Bakker J, Coffernils M, Leon M, et al (1991) Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest 99:956–962
Barandun S, Imbach P, Kindt H, et al (1982) Clinical applications of immunoglobulin. Sandoz, Basle, p 88
Bauer J, Herrmann F (1991) Interleukin-6 in clinical medicine. Ann Hematol 62:203–210
Baumann H, Gauldie J (1990) Regulation of hepatic acute phase plasma protein genes by hepatocyte stimulating factors and other mediators of inflammation. Mol Biol Med 7:147–159
Baumgartner J-D (1992) Anti-endotoxin therapy in the management of sepsis. J Antimicrob Chemother 29:360–362
Baumgartner J-D, McCuthan JA, Van Melle G, et al (1985) Prevention of gram-negative shock and death in surgical patients by antibody to endotoxin core glycolipid. Lancet II:59–63
Bekes CE, Bayly RW, Dellinger RP, et al (1992) Guidelines for the care of patients with hemodynamic instability associated with sepsis. Crit Care Med 20:1057–1059
Benjamin E, Liebowitz AB, Oropello J, Iberti TS (1992) Systemic hypoxic and inflammatory syndrome: an alternative designation for sepsis syndrome. Crit Care Med 20:680–682
Berkman SA, Lee ML, Gale RP (1990) Clinical uses of intravenous immunoglobulins. Ann Intern Med 112:278–292
Bernat A, Herbert JM, Salel V, et al (1992) Protective effect of SR 27417, a novel PAF antagonist, on PAF- or endotoxin-induced hypotension in the rat and the guinea-pig. J Lipid Mediators 5:41–48
Bodey GP (1993) Empirical antibiotic therapy for fever in neutropenic patients. Clin Infect Dis 17 [Suppl 2]: 378–384
Bodey GP, Rodriguez V, Chang H-Y, Narboni G (1978) Fever and infection in leukemic patient. A study of 494 consecutive cases. Cancer 41:1610–1622
Bodey GP, Bolivar R, Fainstein V (1982) Infectious complications in leukemic patients. Semin Hematol 19:193–226
Bollaert PE, Bauer P, Audibert G, et al (1990) Effects of epinephrine on hemodynamics and oxygen metabolism in dopamine-resistant septic shock. Chest 98:949–953
Bone RC (1991) Sepsis, the sepsis syndrome, multi-organ failure: a plea for comparable definitions. Ann Intern Med 114:332–333
Bone RC (1991) Let's agree on terminology: definitions of sepsis. Crit Care Med 19:973–976
Bone RC (1991) The pathogenesis of sepsis. Ann Intern Med 115:457–469
Bone RC (1991) A critical evaluation of new agents for treatment of sepsis. JAMA 266:1686–1691
Bone RC (1992) Modulators of coagulation. A critical appraisal of their role in sepsis. Arch Intern Med 152:1381–1389
Bone RC (1992) Toward an epidemiology and natural history of SIRS (systemic inflammatory response syndrome). JAMA 268:3452–3455
Bone RC, Fisher C, Clemmer TP (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317:653–658
Bone RC, Sibbald WJ, Sprung CL (1992) The ACCP-SCCM consensus conference on sepsis and organ failure. Chest 101:1481–1482
Bone RC, Balk RA, Cerra FB, et al (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101:1644–1655
Bone RC, Balk RA, Cerra FB, et al (1992) American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874
Briegel J, Forst H, Hellinger H, Haller M (1991) Contribution of cortisol deficiency to septic shock. Lancet 338:507–508
Buckley RH, Schiff RI (1991) The use of intravenous immunoglobulin in immunodeficiency disease. N Engl J Med 325:110–115
Calandra T, Glauser MP, Schellekens J, et al (1988) Treatment of gram-negative septic shock with human IgG antibody to Escherichia coli J5. J Infect Dis 158:312–319
Calandra T, Gerain J, Heumann D, et al (1991) High circulating levels of interleukin-6 in patients with septic shock: evolution during sepsis, prognostic value, and interplay with other cytokines. Am J Med 91:23–30
Casey LC, Balk RA, Bone RC (1993) Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Ann Intern Med 119:771–778
Cavallion J-M, Munoz C, Fitting C, et al (1992) Circulating cytokines: the tip of the iceberg? Circ Shock 38:145–152
Chang H-Y, Rodriguez V, Narboni G, Bodey GP, Luna MA, Freireich EJ (1976) Causes of death in adults with acute leukemia. Medicine 55:259–268
Clemmer TP, Fisher CJ, Bone RC, et al (1992) Hypothermia in the sepsis syndrome and clinical outcome. Crit Care Med 20:1395–1401
Clevenger FW (1993) Nutritional support in the patient with the systemic inflammatory response syndrome. Am J Surg 165 [Suppl 2A]: 68–74
Cohen I L (1993) Definitions for sepsis and organ failure. The ACCP/SCCM Consensus Conference Committee report. Chest 103:656
Cohn J, Bone RC (1992) New strategies in nonantibiotic treatment of gram-negative sepsis. Cleve Clin J Med 59:608–615
Cohen J, Exley AR (1993) Treatment of septic shock with antibodies to tumour necrosis factor. Schweiz Med Wochenschr 123:492–496
Colardyn FC, Vandenbogaerde JF, Vogelaers DP, et al (1989) Use of dopexamin hydrochloride in patients with septic shock. Crit Care Med 17:999–1003
Corriveau CC, Danner RL (1993) Antiendotoxin therapies for septic shock. Infect Agents Dis 2:44–52
Crespo MS, Fernandez-Gallardo S (1991) Pharmacological modulation of PAF: a therapeutic approach to endotoxin shock. J Lipid Mediators 4:127–144
Cross AS, Opal SM, Palardy JE, et al (1993) The efficacy of combination immunotherapy in experimental Pseudomonas sepsis. J Infect Dis 167:112–118
Cunnion RE (1990) Myocardial depressant substance. Ann Intern Med 113:237–239
Damas P, Reuter A, Gysen P, et al (1989) Tumor necrosis factor and interleukin-1 serum levels during severe sepsis in humans. Crit Care Med 17:975–978
Danner RL (1990) Mediators and endotoxin inhibitors. Ann Intern Med 113:235–237
Dantzker DR (1993) Adequacy of tissue oxygenation. Crit Care Med 21 [Suppl 2]:S40-S43
De Boer JP, Wolbink GJ, Thijs LG, et al (1992) Interplay of complement and cytokines in the pathogenesis of septic shock. Immunopharmacology 24:135–148
Dhainaut JF, Edwards JD, Grootendorst AF, et al (1990) Practical aspects of oxygen transport: conclusions and recommendations of the roundtable conference. Intensive Care Med 16 [Suppl 2]:179–180
Dinarello CA (1991) Interleukin-1 and interleukin-1 antagonism. Blood 77:1627–1652
Dinarello CA, Cannon JG (1993) Cytokine measurements in septic shock. Ann Intern Med 119:853–854
Dinarello CA, Wolff SM (1993) The role of interleukin-1 in disease. N Engl J Med 328:106–113
Dofferhoff ASM (1991) The role of cytokines in septic shock and speculations on future therapies. Neth J Med 39:1–5
Dofferhoff ASM, Vellenga E, Limburg PC, et al (1991) Tumour necrosis factor (cachectin) and other cytokines in septic shock: a review of the literature. Neth J Med 38:46–63
Dofferhoff ASM, De Jong DJ, Bom VJJ, et al (1992) Complement activation and the production of inflammatory mediators during the treatment of severe sepsis in humans. Scand J Infect Dis 24:197–204
Dominioni L, Dionigi R, Zanello M (1991) Effect of high-dose IgG on survival of surgical patients with sepsis score of 20 or greater. Arch Surg 126:236–240
Duke GJ, Bersten AD (1992) Dopamine and renal salvage in the critically ill patient. Anaesth Intensive Care 20:277–302
Emerson TE Jr, Lindsey DC, Jesmok GJ, et al (1992) Efficacy of monoclonal antibody against tumor necrosis factor alpha in an endotoxemic baboon model. Circ Shock 38:75–84
Endo S, Inada K, Inoue Y, et al (1992) Two types of septic shock classified by the plasma levels of cytokines and endotoxin. Circ Shock 38:264–274
Estey EH, Keating MJ, McCredie KM, Bodey GP, Freireich EJ (1982) Causes of initial remission induction failure in acute myelogenous leukemia. Blood 60:309–315
Exley AR, Cohen J, Buurman W, et al (1992) Monoclonal antibody to TNF in severe septic shock. Lancet 335:1275–1277
Fiedler VB, Loof I, Sander E, et al (1992) Monoclonal antibody to tumor necrosis factor-alpha prevents lethal endotoxin sepsis in adult rhesus monkeys. J Lab Clin Med 120:574–588
Fink MP (1993) Adoptive immunotherapy of gram-negative sepsis use of monoclonal antibodies to lipopolysaccharide. Crit Care Med 21: S32-S39
Fischer JE, Hasselgren P-O (1991) Cytokines and glucocorticoids in the regulation of the “hepato-skeletal muscle axis” in sepsis. Am J Surg 161:266–271
Fisher CJ Jr, Opal SM, Dhainaut J-F, et al (1993) Influence of an antitumor necrosis factor monoclonal antibody on cytokine levels in patients with sepsis. Crit Care Med 21:318–327
Fisher CJ, Slotman GJ, Opal SM, et al (1994) Initial evaluation of human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome: a randomized, open labeled, placebo controlled multicenter trial. Crit Care Med 22:12–21
Fletcher JR (1991) Ibuprofen in patients with severe sepsis. Crit Care Med 19:1331–1332
Fourrier F, Chopin C, Goudemand J, et al (1991) Septic shock, multiple organ failure and disseminated intravascular coagulation. Compared patterns of antithrombin III, protein C, and protein S deficiencies. Chest 101:816–823
Fudenberg HH, Fudenberg HH (1989) Transfer factor: past, present and future. Ann Rev Pharmacol Toxicol 29:475–516
Goris RJA (1990) Mediators of multiple organ failure. Intensive Care Med 16 [Suppl 3]:191–196
Greenman RL, Schein RMH, Martin MA, et al (1991) A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis. JAMA 266:1097–1102
Gregory JS, Bonfiglio MF, Dasta JF, et al (1991) Experience with phenylephrine as component of the pharmacologic support of septic shock. Crit Care Med 19:1395–1400
Groeneveld ABJ (1990) Septic shock and multiple organ failure treatment with hemofiltration? Intensive Care Med 16:489–490
Hack CE, De Groot ER, Felt-Bersma RJF, et al (1989) Increased plasma levels of interleukin-6 in sepsis. Blood 74:1704–1710
Hack CE, Hart M, Strack RJM, et al (1992) Interleukin-8 in sepsis: relation to shock and inflammatory mediators. Infect Immun 60:350–358
Hackshaw KV, Parker GA, Roberts JW (1990) Naloxone in septic shock. Crit Care Med 18:47–51
Hanique G, Dugernier T, Laterre PF, et al (1994) Significance of pathologic oxygen supply dependency in critically ill patients: comparison between measured and calculated methods. Intensive Care Med 20:12–18
Harbour DV, Galin FS, Hughes TK, et al (1991) Role of leukocyte-derived pro-opiomelanocortin peptides in endotoxic shock. Circ Shock 35:181–191
Haupt MT, Jastremski MS, Clemmer TP, et al (1991) Effect of ibuprofen in patients with severe sepsis: a randomized, double-blind, multicenter study. Crit Care Med 19:1339–1347
Hoffkens HG, Ehrlly AM (1992) Optimal hematocrit in patients with intermittent claudications. Exercise induced muscle tissue oxygen pressure after stepwise isovolemic hemodilution. Clin Hemorheol 12 [Suppl 1]:41–55
Hotchkiss RS, Karl IE (1992) Reevaluation of the role of cellular hypoxia and bioenergetic failure in sepsis. JAMA 267:1503–1510
Jesmok G, Lindsey C, Duerr M, et al (1992) Efficacy of monoclonal antibody against human recombinant tumor necrosis factor in E. coli-challenged swine. Am J Pathol 141:1197–1207
John RCS, Dorinsky PM (1993) Immunologic therapy for ARDS, septic shock and multiple-organ failure. Chest 103:932–943
Klastersky J (1993) Empirical antibiotic therapy in neutropenic cancer patients. Eur J Cancer 22A [Suppl 1]: S6-S10
Kreimeier U, Ruiz-Moralez M, Messmer K (1993) Comparsion of the effects of volume resuscitation with dextran 60 vs Ringer's lactate on central hemodynamics, regional blood flow, pulmonary function, and blood composition during hyperdynamic endotoxemia. Circ Shock 39:89–99
Lanser K, Balikcioglu S (1988) Continuous intravenous infusion of immunoglobulin M in septic shock. In: Deicher H, Schoeppe W (eds) Klinisch angewandte Immunologie. Springer, Berlin Heidelberg New York, pp 42–49
Leach RM, Treacher DF (1992) Oxygen transport: the relation between oxygen delivery and consumption. Thorax 47:971–978
Levi M, Cate H ten, Poll T van der, et al (1993) Pathogenesis of disseminated intravascular coagulation in sepsis. JAMA 270:975–979
Levine AS, Schimpff SC, Graw RG, Young RC (1974) Hematologic malignancies and other marrow failure states: progress in the management of complicating infections. Semin Hematol 11:141–202
Marchant A, Deviere J, Byl B, et al (1994) Interleukin-10 production during septicaemia. Lancet 343:707–708
Marks JD, Marks CB, Luce JM, et al (1990) Plasma tumor necrosis factor in patients ith septic shock. Am Rev Respir Dis 141:94–97
Martich GD, Boujoukos AJ, Suffredini AF (1993) Response of man to endotoxin. Immunobiol 197:403–416
Martin C, Papazian L, Perrin G, et al (1993) Norepinephrine or dopamine for the treatment of hyperdynamic septic shock. Chest 103:1826–1831
Maynard N, Bihari D, Beale R, et al (1993) Assessment of splanchnic oxygenation by gastric tonometry in patients with acute circulatory failure. JAMA 270:1203–1210
McClelland P, Williams PS, Yaqoob M, et al (1990) Multiple organ failure — a role for plasma exchange? Intensive Care Med 16:100–103
McManus ML, Churchwell KB (1993) Coagulopathy as a predictor of outcome in meningococcal sepsis and the systemic inflammatory response syndrome with purpura. Crit Care Med 21:706–711
Mileski WJ (1991) Sepsis. What it is and how to recognize it. Surg Clin North Am 71:749–764
Mitsuo T, Shimazaki S, Matsuda H (1992) Right ventricular dysfunction in septic patients. Crit Care Med 20:630–634
Molooy RG, Mannick JA, Rodrick ML (1993) Cytokines, sepsis and immunomodulation. Br J Surg 80:289–297
Moran JL, O'Fathartaigh MS, Peisach AR, et al (1993) Epinephrine as an inotropic agent in septic shock: a dose-profile analysis. Crit Care Med 21:70–77
Morrison HM, Doepfner P, Park GR (1991) Vasopressin in septic shock — a useful of dangerous agent? Intensive Care Med 17:243–243
Munoz C, Misset B, Fitting C, et al (1991) Dissociation between plasma and monocyte-associated cytokines during sepsis. Eur J Immunol 21:2177–2184
Nasraway SA, Rackow EC, Astiz ME, et al (1989) Inotropic response to digoxin and dopamine in patients with severe sepsis, cardiac failure and systemic hypoperfusion. Chest 95:612–617
Natanson C (1990) A canine model of septic shock. Ann Intern Med 113:231–233
Nydegger UE (1992) Intravenous immunoglobulin in combination with other prophylactic and therapeutic measures. Transfusion 32:72–82
Ognibene FP (1990) Management of septic shock. Ann Intern Med 113:239–240
Packman MI, Rackow EC (1983) Optimal left heart filling pressure during fluid resuscitation of patients with hypovolemia and septic shock. Crit Care Med 11:165–169
Parker MM (1990) Cardiac dysfunction in human septic shock. Ann Intern Med 113:229–231
Parrillo JE (1990) Septic shock in humans. Advances in the understanding of pathogenesis, cardiovascular dysfunction, and therapy. Ann Intern Med 113:227–242
Parrillo JE (1993) Pathogenetic mechanism of septic shock. N Engl J Med 328:1471–1477
Perret C (1992) Sepsis: la confusion des termes. Schweiz Med Wochenschr 122:758–761
Pilz G, Kaab S, Neeser G, et al (1991) Supplemental immunoglobulin treatment in 163 patients with sepsis and septic shock. Infection 19:216–227
Pilz G, Fateh-Moghadam S, Viell B, et al (1993) Supplemental immunoglobulin therapy in sepsis and septic shock — comparison of mortality under treatment with polyvalent i.v. immunoglobulin versus placebo. Protocol of a multicenter, randomized, prospective, double-blind trial. Theor Surg 8:61–83
Pinsky MR, Vincent J-L, Deviere J, et al (1993) Serum cytokine levels in human septic shock. Relation to multiple-organ failure and mortality. Chest 103:565–575
Pizzo PA (1993) Management of fever in patients with cancer and treatment — induced neutropenia. N Engl J Med 328:1323–1332
Pollack M (1992) Editorial response: blood exchange and plasmapheresis in sepsis and septic shock. Clin Infect Dis 15:431–433
Preiser JC, Schmartz D, Van der Linden P, et al (1991) Interleukin-6 administration has no acute hemodynamic or hematologic effect in the dog. Cytokine 3:1–4
Quezado ZMN, Natanson C, Alling DW, et al (1993) A controlled trial of HA-1A in a canine model of gram-negative septic shock. JAMA 269:2221–2227
Rackow EC, Astiz ME (1991) Pathophysiology and treatment of septic shock. JAMA 266:548–554
Reinhart K, Hannemann L, Kuss B (1990) Optimal oxygen delivery in critically ill patients. Intensive Care Med 16 [Suppl 2]:149–155
Roman J, Fernandez F, Velasco F, et al (1993) Serum TNF levels in neonatal sepsis and septic schock. Acta Paediatr 82:352–354
Ronco JJ, Fenwick JC, Tweeddale MG, et al (1993) Identification of the critical oxygen delivery for anaerobic metabolism in critically ill septic and nonseptic human. JAMA 270:1724–1730
Schaer GL, Fink MP, Parrillo JE (1985) Norepinephrine alone versus norepinephrine plus low-dose dopamine: enhanced renal blood flow with combination pressor therapy. Crit Care Med 13:492–496
Schedel I, Dreikhausen U, Nentwig B, et al (1991) Treatment of gram-negative septic shock with an immunoglobulin preparation: a prospective, randomized clinical trial. Crit Care Med 19:1104–1113
Schimpff SC (1993) Gram-negative bacteremia. Support Care Cancer 1:5–8
Schneider AJ, Voerman HJ (1991) Abrupt hemodynamic improvement in late septic shock with physiological doses of glucocorticoids. Intensive Care Med 17:436–437
Schulman KA, Glick HA, Rubin H, Eisengerg JM (1991) Cost-effectiveness of HA-1A monoclonal antibody for gram-negative sepsis. Economic assessment of new therapeutic agent. JAMA 266:3466–3471
Shibutani K, Komatsu T, Kubal K, et al (1983) Critical level of oxygen delivery in anesthetized man. Crit Care Med 11:640–645
Sjolin J (1991) High dose corticosteroids therapy in human septic shock: has the jury reached a correct verdict? Circ Shock 35:139–451
Smithies M, Bihari DJ (1993) Delivery dependent oxygen consumption: asking the wrong questions and not getting any answers. Crit Care Med 1993:1622–1626
Snell RJ, Parrillo JE (1991) Cardiovascular dysfunction in septic shock. Chest 99:1000–1009
Sprung CL (1991) Definitions of sepsis — have we reached a consensus? Crit Care Med 19:849–851
Sprung CL, Caralis PV, Marcial EH (1984) The effects of high-dose corticosteroids in patients with septic shock. A prospective, controlled study. N Engl J Med 311:1137–1143
Stanford GG (1991) Use of inotropic agents in critical illness. Surg Clin North Am 71:683–698
Steinmetz HT, Bertram M, Riediger A, et al (1993) Pattern of cytokines in leucopenic fever (abstract). Ann Hematol 67: A122
Suffredini AF (1990) Endotoxin administration to normal humans. Ann Intern Med 113:233–235
Takala J, Ruokonen E (1992) Oxygen transport in septic shock. Schweiz Med Wochenschr 122:776–779
Taylor FB Jr, Chang A, Ruf W, et al (1991) Lethal E. coli septic shock is prevented by blocking tissue factor with monoclonal antibody. Circ Shock 33:127–134
The Veterans Administration Systemic Sepsis Cooperative Study Group (1987) Effect of high dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317:659–665
Todd AAM, Yap PL (1992) Applications of intravenous immunoglobulin in haematology. Blood Rev 6:105–117
Tompkins RG (1994) Human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome. Crit Care Med 22:3
Tracey KJ (1991) Tumor necrosis factor (cachectin) in the biology of septic shock syndrome. Circ Shock 35:123–128
Tuschschmidt J, Fried J, Swinney R, Sharma OP (1989) Early hemodynamic correlates of survival in patients with septic shock. Crit Care Med 17:719–723
Tuchschmidt J, Oblitas D, Fried C (1991) Oxygen consumption in sepsis and septic shock. Crit Care Med 19:664–671
Van der Meer Jos WM (1988) Defects in host-defense mechanisms. In: Rubin R H, Young LS (eds) Clinical approach to infection in the compromised host. Plenum Press, New York, p 685
Van der Poll T, Sauerwein HP (1993) Tumor necrosis factor alpha: its role in the metabolic response to sepsis. Clin Sci 84:247–256
Van Zee KJ, DeForge LE, Fischer E, et al (1991) IL-8 in septic shock, endotoxemia, and after IL-1 administration. J Immunol 146:3478–3482
Villard J, Roux-Lombard P, Hugli A, et al (1993) Could natural inhibitors of tumor necrosis factor alpha modify the clinical course of fulminant meningococcemia? Crit Care Med 21:1396–1400
Vincent J-L (1991) Advances in the concepts of intensive care. Am Heart J 121:1859–1865
Vincent J-L (1993) Oxygen transport in severe sepsis. Acta Anaesthesiol Scand 37 [Suppl 98]:29–31
Vincent J-L (1994) Renal effects of dopamine: can our dream ever come true? Crit Care Med 22:5–6
Vincent J-L, Bihari D (1992) Sepsis, severe sepsis or sepsis syndrome: need for clarifications. Intensive Care Med 18:255–257
Vincent J-L, Boelpaepe C, Luypaert P, et al (1988) Association of amrinone with norepinephrine in endotoxic shock in dogs (abstract). Crit Care Med 16:402
Vincent J-L, Gris P, Coffernils M, et al (1992) Myocardial depression characterizes the fatal course of septic shock. Surgery 111:660–667
Vincent J-L, Bakker J, Marcecaux G, et al (1992) Administration of anti-TNF antibody improves left ventricular function in septic shock patients. Chest 101:810–815
Vogel F (1988) Assessment of intravenous IgM therapy in severe nosocomial infections: results of a controlled randomized study. In: Deicher H, Schoeppe W (eds) Klinisch angewandte Immunologie. Springer, Berlin Heidelberg New York, pp 30–41
Wade JC, Schimpff SC (1988) Epidemiology and prevention of infection in the compromised host. In: Rubin RH, Young LS (eds) Clinical approach to infection in the compromised host. Plenum Press, New York, p 685
Warren HS, Danner RL, Munford RS (1992) Anti-endotoxin monoclonal antibodies. N Engl J Med 326:1153–1157
Wenzel RP (1992) Anti-endotoxin monoclonal antibodies — a second look. N Engl J Med 326:1151–1153
Wilson W, Lipman J, Scribante J, et al (1992) Septic shock: does adrenalin have a role as a first-line agent? Anaesth Intensive Care 20:470–474
Wortel CH, Mohlen AM von der, Deventer SJH van, et al (1992) Effectiveness of a human monoclonal anti-endotoxin antibody (HA-1A) in a gram-negative sepsis. J Infect Dis 166:1367–1374
Yoshikawa D, Gotto F (1992) Effect of platelet-activating factor antagonist and leukotriene antagonist on endotoxin shock in the rat: role of the leukocyte. Circ Shock 38:29–33
Ziegler EJ, McCuthan A, Fierer J, et al (1982) Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli. N Engl J Med 307:1225–1230
Ziegler EJ, Fisher CJ Jr, Sprung CL, et al (1991) Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. N Engl J Med 324:429–436
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Mayer, J., Hajek, R., Vorlicek, J. et al. Sepsis and septic shock. Support Care Cancer 3, 111–119 (1995). https://doi.org/10.1007/BF00365850
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DOI: https://doi.org/10.1007/BF00365850