Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Critical care

A silver lining in the quest for improved survival in sepsis

Two recent trials have highlighted that our strategies to restore tissue perfusion early and decrease mortality in patients with sepsis are varied and evidence for an effective therapy to reduce the incidence of kidney injury is lacking. However, newly reported data suggest an overall improved standard of care for patients.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    Caironi, P. et al. Albumin replacement in patients with severe sepsis or septic shock. N. Engl. J. Med. 370, 1412–1421 (2014).

    CAS  Article  Google Scholar 

  2. 2

    Asfar, P. et al. High versus low blood-pressure target in patients with septic shock. N. Engl. J. Med. http://dx.doi.org/10.1056/NEJMoa1312173.

  3. 3

    Kaukonen, K. M., Bailey, M., Suzuki, S., Pilcher, D. & Bellomo, R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000–2012. JAMA 311, 1308–1316 (2014).

    CAS  Article  Google Scholar 

  4. 4

    Cochrane Injuries Group Albumin Reviewers. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 317, 235–240 (1998).

    Article  Google Scholar 

  5. 5

    Finfer, S. et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N. Engl. J. Med. 350, 2247–2256 (2004).

    CAS  Article  Google Scholar 

  6. 6

    Delaney, A. P., Dan, A., McCaffrey, J. & Finfer, S. The role of albumin as a resuscitation fluid for patients with sepsis: a systematic review and meta-analysis. Crit. Care Med. 39, 386–391 (2011).

    CAS  Article  Google Scholar 

  7. 7

    Parving, H. P. & Gyntelberg, F. Transcapillary escape rate of albumin and plasma volume in essential hypertension. Circ. Res. 32, 643–651 (1973).

    CAS  Article  Google Scholar 

  8. 8

    Fleck, A. et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury. Lancet 1, 781–784 (1985).

    CAS  Article  Google Scholar 

  9. 9

    Kelleher, S. P., Robinette, J. B. & Conger, J. D. Sympathetic nervous system in the loss of autoregulation in acute renal failure. Am. J. Physiol. 246, F379–F386 (1984).

    CAS  PubMed  Google Scholar 

  10. 10

    Annane, D. et al. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial. Lancet 370, 676–684 (2007).

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to A. Ahsan Ejaz.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mohandas, R., Ejaz, A. A silver lining in the quest for improved survival in sepsis. Nat Rev Nephrol 10, 302–304 (2014). https://doi.org/10.1038/nrneph.2014.77

Download citation

Further reading

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing