Septic Shock (Toxic Shock Syndrome)

Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include, but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.

Also Known As:

Networked: 9803 relevant articles (633 outcomes, 1310 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Sepsis (Septicemia)
2.	Shock
3.	Infection
4.	Peritonitis
5.	Multiple Organ Failure (MODS)

Experts

1.	Vincent, Jean-Louis: 75 articles (01/2016 - 01/2002)
2.	Annane, Djillali: 52 articles (02/2016 - 06/2002)
3.	Westphal, Martin: 40 articles (10/2013 - 09/2005)
4.	Russell, James A: 39 articles (03/2015 - 03/2002)
5.	Wong, Hector R: 35 articles (10/2015 - 05/2002)
6.	Monneret, Guillaume: 34 articles (08/2014 - 09/2002)
7.	Walley, Keith R: 33 articles (03/2015 - 03/2002)
8.	Morelli, Andrea: 33 articles (01/2015 - 04/2004)
9.	Kumar, Anand: 32 articles (07/2015 - 10/2002)
10.	De Backer, Daniel: 31 articles (05/2015 - 01/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Septic Shock:

1.	Tumor Necrosis Factor-alpha (Tumor Necrosis Factor)IBA 03/01/2000 - "Very early determination of TNF-alpha and ET-1 in septic shock may help to identify patients at higher risk for adverse outcome." 01/01/2012 - "In agreement with the in vitro study, β-thujaplicin was shown to be effective in vivo for inhibiting LPS-induced NO and TNF-alpha production and a significant decrease in mortality rate of mice suffering from septic shock was observed. " 03/01/2002 - "Moreover, TNF-alpha responses obtained with high-dose lipopolysaccharide were significantly greater in cells from patients who subsequently survived septic shock (n=13; median value 1392 pg/ml; range 592-2048 pg/ml) than in cells from non-survivors (n=7; median value 708 pg/ml; range 520-1344 pg/ml). " 09/01/1997 - "LPS, J5 LPS, or TNF-alpha was beneficial in preventing endotoxic shock in the newborn." 03/22/1995 - "In septic shock patients who received TNF-alpha MAb, a significant reduction in mortality was present 3 days after infusion. "
2.	Polymyxin B (Aerosporin)FDA LinkGeneric 08/01/2007 - "Early initiation of polymyxin B-immobilized fiber therapy effective for septic shock after aortic replacement." 04/01/2010 - "Effectiveness of endotoxin scattering photometry for determining the efficacy of polymyxin B-immobilized fiber treatment in septic shock: report of a case." 11/01/2015 - "Polymyxin B haemoperfusion in septic shock patients." 01/01/2011 - "Cost-effectiveness analysis of polymyxin-B immobilized fiber column and conventional medical therapy in the management of abdominal septic shock in Italy." 01/01/2010 - "Application of polymyxin B convalently immobilized fiber in patients with septic shock."
3.	Hydrocortisone (Cortisol)FDA LinkGeneric 05/01/2008 - "Recent results from the CORTICUS study have not confirmed previous beneficial results and have led to restrictions in the use of hydrocortisone substitution therapy in patients with septic shock. " 12/01/1999 - "Two recent small randomized trials evaluating a 5- to 12-day course of low dose hydrocortisone in patients with septic shock have reported a significant clinical improvement and a reduction in mortality. " 04/01/1998 - "Administration of modest doses of hydrocortisone in the setting of pressor-dependent septic shock for a mean of >96 hrs resulted in a significant improvement in hemodynamics and a beneficial effect on survival. " 01/01/2003 - "Recently, a new concept has emerged with more promising results--low dose, long-term hydrocortisone therapy- and this approach is now being evaluated in the treatment of septic shock. " 07/01/2008 - "Is hydrocortisone an effective treatment for septic shock?"
4.	Norepinephrine (Noradrenaline)FDA LinkGeneric 05/01/2012 - "A subgroup analysis that pooled studies in which all the randomized patients had septic shock demonstrated that norepinephrine improved in-hospital or 28-day mortality; however, the results were no longer statistically significant. " 01/01/1998 - "Selective iNOS inhibition is superior to norepinephrine in the treatment of rat endotoxic shock." 10/01/2010 - "The results from one large randomized clinical trial suggest that AVP plus norepinephrine (NE) infusion is as safe and effective as treatment with NE alone in patients with septic shock. " 01/01/2008 - "In a resuscitated porcine model of the early phase of septic shock, SNP improved ileal mucosal MBF but required a concomitant increase in fluid and norepinephrine supplements to maintain constant systemic haemodynamic parameters." 06/01/2002 - "Norepinephrine, administered to increase mean arterial pressure by 10 mm Hg in an acute model of volume-resuscitated endotoxic shock, improved systemic and regional perfusion. "
5.	Vasopressins (Vasopressin)IBA 06/01/2013 - "We found a significant reduction of the mortality rate in septic shock patients who received vasopressin compared with PMX. " 09/01/2012 - "Vasopressin treatment in septic shock is associated with a significant reduction in heart rate but no change in cardiac output or other measures of perfusion. " 10/01/2009 - "However, vasopressin may be beneficial in the less severe septic shock subgroup. " 02/01/2009 - "However, vasopressin may be beneficial in the less severe septic shock subgroup. " 12/01/2004 - "There is growing evidence that vasopressin infusion in septic shock is safe and effective. "
6.	OxygenIBA 11/01/2013 - "High volume hemofiltration (HVHF) at early stage of septic shock piglet models was more effective in improving hemodynamics, oxygen metabolism than conventional CVVH. " 12/15/2003 - "The use of noninvasive ventilation prevented intubation, reduced the incidence of septic shock, and improved survival in these patients compared with high-concentration oxygen therapy." 12/01/2014 - "Transfusion of red blood cells is associated with improved central venous oxygen saturation but not mortality in septic shock patients." 10/01/2012 - "Transfusion of packed red blood cells is not associated with improved central venous oxygen saturation or organ function in patients with septic shock." 02/01/2008 - "During early hyperdynamic porcine septic shock, 100% oxygen improved organ function and attenuated tissue apoptosis without affecting lung function and oxidative or nitrosative stress. "
7.	Anti-Bacterial Agents (Antibiotics)IBA 01/01/2008 - "In our retrospective study, early adequate antibiotics and achieving adequate global perfusion, but not liberal vasopressor therapy, were associated with improved organ failures after septic shock. " 01/01/2015 - "Targeting TREM-1 Signaling in the Presence of Antibiotics is Effective Against Streptococcal Toxic-Shock-Like Syndrome (STSLS) Caused by Streptococcus suis." 10/01/2007 - "They were treated with the protocol for septic shock, antibiotics and rPC activator from the time of admission, and improvement in hemodynamic dysfunction was observed within hours in all patients. " 08/01/2013 - "The objective of the present study was to describe the factors associated with delays in the delivery of appropriate antibiotics to patients admitted to the intensive care unit (ICU) from the ED or wards with septic shock. " 05/01/2009 - "Although previous studies have shown that de-escalation therapy (DT) of antibiotics may decrease costs and the development of resistant pathogens, minimal data have shown its effect in surgical patients or in any patients with septic shock. "
8.	Protein CIBA 01/01/2009 - "Recombinant human activated Protein C (APC) is used as an adjunctive therapeutic treatment in septic shock. " 09/01/2014 - "Among patients with septic shock, do-not-resuscitate status acts as a strong confounder that may inform past discrepancies between observational and randomized studies of activated protein C. " 11/01/2012 - "Improvements in general quality of care such as speed of antimicrobial delivery leading to decreasing mortality of patients with septic shock may have contributed to the null results of the recently completed trial of recombinant human activated protein C in patients with septic shock." 11/01/2012 - "To evaluate the effectiveness of recombinant human activated protein C on mortality in a cohort of patients with septic shock and to explore possible reasons for inconsistent results in previous studies. " 11/01/2008 - "Design, conduct, analysis and reporting of a multi-national placebo-controlled trial of activated protein C for persistent septic shock."
9.	Adrenal Cortex Hormones (Corticosteroids)IBA 09/01/2003 - "The use of corticosteroids in patients with septic shock has been recently revisited and the use of low dose corticosteroids led to very promising results, particularly in patients with corticosteroid insufficiency. " 01/01/1987 - "Drugs which alter eicosanoid production such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAID) are beneficial in treating endotoxic shock. " 01/01/1985 - "High doses of corticosteroids are reported to be beneficial in the treatment of septic shock in many animal species, e.g. " 09/01/1976 - "A prospective (Part I) and a retrospective (Part II) study were used to determine the safety and efficacy of corticosteroids in the treatment of septic shock. " 07/01/2009 - "Safety and efficacy of corticosteroids for the treatment of septic shock: A systematic review and meta-analysis."
10.	drotrecogin alfa activated (Xigris)FDA Link 01/01/2011 - "We hypothesized that patients with septic shock who were treated with rhAPC had an improved in-hospital mortality compared to patients with septic shock with similar acuity who did not receive rhAPC. " 12/01/2011 - "In this single-center study, we identified 17 patients with a SOT and septic shock who received rhaPC. " 01/01/2013 - "Ranieri VM, Thompson BT, Barie PS, Dhainaut JF, Douglas IS, Finfer S, Gårdlund B, Marshall JC, Rhodes A, Artigas A, Payen D, Tenhunen J, Al-Khalidi HR, Thompson V, Janes J, Macias WL, Vangerow B, Williams MD: Drotrecogin alfa (activated) in adult patients with septic shock. " 09/06/2012 - "Drotrecogin alfa (activated) in septic shock." 09/06/2012 - "Drotrecogin alfa (activated) in septic shock."

Therapies and Procedures

1.	Resuscitation 04/01/2008 - "After resuscitation, all the solutions improved the hemodynamics of septic shock dogs with significant differences (P<0.05). " 04/01/2004 - "There is evidence suggesting that early fluid resuscitation is beneficial in the treatment of septic shock. " 10/01/2003 - "The objective of this study was to determine whether early septic shock reversal and use of resuscitation practice consistent with the new ACCM-PALS Guidelines by community physicians is associated with improved outcome. " 11/02/2002 - "Improved recruitment of the microcirculation could be a new resuscitation endpoint in septic shock." 04/01/2010 - "In this animal model of endotoxemic-induced septic shock that results in severe myocardial depression, HDI is associated with improved cardiac function compared to NS resuscitation alone. "
2.	Hemoperfusion 10/01/2007 - "Direct hemoperfusion with the PMX-05R column is effective in ameliorating clinical and laboratory abnormalities in elderly septic shock patients." 01/01/2006 - "Direct hemoperfusion (DHP) with polymixin B-immobilized fiber (PMX) has been reported to be effective for patients with septic shock. " 02/01/2013 - "We sought to investigate the role of CD4(+)CD25(+)Foxp3(+) Tregs in septic patients, and to evaluate the effect of hemoperfusion with PMX-F on the recovery from immunosuppression owing to septic shock. " 01/01/2010 - "We treated 36 patients with septic shock using direct hemoperfusion with PMX. " 10/01/2007 - "We performed direct hemoperfusion twice with the PMX-05R column in 8 septic shock patients who were over 80 years of age. "
3.	Intensive Care (Surgical Intensive Care) 03/01/2011 - "We observed a marked decrease in quadriceps volume within the first week of intensive care for septic shock. " 10/17/2007 - "Indeed, procalcitonine has proven effective in the intensive care setting, as a diagnostic aid for septic shock, as a prognostic instrument and to tailor the duration of antibiotic treatment. " 03/01/2000 - "Septic shock was effectively treated in 12 patients, 5 of them were discharged from the department (group 1) and 7 died in intensive care wards from various complications (group 2). " 04/01/2001 - "Septic shock was not improved in patient 1 and 2 despite intensive care. " 02/01/2006 - "This was a prospective randomized study performed in a surgical intensive care unit among adults fulfilling usual criteria for septic shock. "
4.	Drug Therapy (Chemotherapy) 11/01/1989 - "The chromosomal analysis of marrow cells by G-banding revealed 47, XY, +4. In spite of administration of chemotherapy complete remission was not obtained, and he died of septic shock and severe liver damage 4 months after making the diagnosis. " 08/01/2011 - "Although additional chemotherapy was administered, the patient could not attain remission and died of septic shock. " 06/01/2009 - "The patient was treated with induction chemotherapy allowing remission, but unfortunately died of septic shock of fungal origin. " 04/01/2013 - "Septic shock: new pharmacotherapy options or better trial design?" 08/01/2012 - "However, no study has evaluated the microvascular pattern of septic shock patients with chemotherapy-induced severe cytopenia. "
5.	Ligation 11/25/2015 - "The phenolic compounds improved the survival rates of cecal ligation and puncture operation (CLP) in murine models, simulating severe septic shock and its related complications, to 40-60%. " 08/01/2013 - "The goal of this study was to investigate the impact of SAHA on survival in a more clinically relevant model of cecal ligation and puncture (CLP)-induced septic shock and to elucidate changes in cytokine responses and organ injury. " 02/01/2013 - "In the present study, we found that Sra(-/-) mice are more resistant to septic shock induced by cecal ligation and puncture than wild-type C57BL/6 J (B6) mice. " 10/01/2012 - "The goal of the present study was to assess the response of STAT1- and TYK2-deficient mice to septic shock caused by cecal ligation and puncture (CLP). " 08/01/2007 - "The present work was designed to study the relationship between ABR function and the survival time of septic shock in a cecal ligation and puncture (CLP) rat model. "