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Open AccessEfficacy and safety of trimodulin, a novel polyclonal antibody preparation, in patients with severe community-acquired pneumonia: a randomized, placebo-controlled, double-blind, multicenter, phase II trial (CIGMA study)
The CIGMA study investigated a novel human polyclonal antibody preparation (trimodulin) containing ~ 23% immunoglobulin (Ig) M, ~ 21% IgA, and ~ 56% IgG as add-on therapy for patients with severe community-acq...
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Open AccessAge, exercise, and the outcome of sepsis
We report on the increasingly important need to diagnose and care for the elderly with sepsis as a distinct patient population. We share an overview of age-related changes in sepsis physiology and the potentia...
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Sepsis: frontiers in supportive care, organisation and research
Because of its high incidence and clinical complexity, sepsis is a major challenge to clinicians and researchers and a global burden to healthcare systems and society. Despite recent progress, short- and long-...
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Should all septic patients be given systemic anticoagulation? No
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Open AccessNon-antibiotic treatments for bacterial diseases in an era of progressive antibiotic resistance
The emergence of multi-drug resistant (MDR) microbial pathogens threatens the very foundation upon which standard antibacterial chemotherapy is based. We must consider non-antibiotic solutions to manage invasi...
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Sepsis and septic shock
For more than two decades, sepsis was defined as a microbial infection that produces fever (or hypothermia), tachycardia, tachypnoea and blood leukocyte changes. Sepsis is now increasingly being considered a d...
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Sepsis in the Severely Immunocompromised Patient
The prevention and treatment of sepsis in the immunocompromised host present a challenging array of diagnostic and management issues. The neutropenic patient has a primary defect in innate immune responses and...
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Open AccessThe dysfunctional host response to influenza A H7N9: a potential treatment option?
The newly emerging human pathogen influenza A H7N9 represents a potentially major threat to human health. The virus was first shown to be pathogenic in humans in 2013, and outbreaks continue to occur in China ...
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Over-distension of the airways by mechanical ventilation in the elderly: adding insult to injury
Setzer and colleagues demonstrate that older animals are more susceptible to ventilator-induced lung injury than young animals and develop a more pronounced local and systemic cytokine response to high tidal v...
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Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012
To provide an update to the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock,” last published in 2008.
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Immune Aspects of Sepsis and Hope for New Therapeutics
Marked alterations of the innate and adaptive immune response follow invasive infection and generalized inflammatory states. If left unchecked, this state of immune dysregulation contributes to a myriad of mal...
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Clinical review: The role of biomarkers in the diagnosis and management of community-acquired pneumonia
In patients with community-acquired pneumonia, traditional criteria of infection based on clinical signs and symptoms, clinical scoring systems, and general inflammatory indicators (for example, leukocytosis, ...
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Year in review 2008: Critical Care - sepsis
The present report highlights the most important papers appearing in Critical Care and other major journals about severe sepsis, the systemic inflammatory response and multiorgan dysfunction over the past year. A...
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Coming soon to an ICU near you: severe pandemic influenza in ICU patients in Spain
A novel strain of swine influenza A H1N1 has already disseminated worldwide and has become a major clinical problem for intensive care units in selected areas. Many regions in the southern hemisphere are curre...
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Swine flu, pandemics, and critical care
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Open AccessA clinical evaluation committee assessment of recombinant human tissue factor pathway inhibitor (tifacogin) in patients with severe community-acquired pneumonia
The purpose of this analysis was to determine the potential efficacy of recombinant human tissue factor pathway inhibitor (tifacogin) in a subpopulation of patients with community-acquired pneumonia (CAP) from...
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Bench-to-bedside review: Quorum sensing and the role of cell-to-cell communication during invasive bacterial infection
Bacteria communicate extensively with each other and employ a communal approach to facilitate survival in hostile environments. A hierarchy of cell-to-cell signaling pathways regulates bacterial growth, metabo...
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Open AccessInhibition of the RAGE products increases survival in experimental models of severe sepsis and systemic infection
The receptor for advanced glycation end products (RAGE), a multi-ligand member of the immunoglobulin superfamily, contributes to acute and chronic disease processes, including sepsis.
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Coagulation abnormalities in critically ill patients
Many critically ill patients develop hemostatic abnormalities, ranging from isolated thrombocytopenia or prolonged global clotting tests to complex defects, such as disseminated intravascular coagulation. Ther...
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Role of Toll-Like Receptors in Infection and Immunity
The remarkable discovery of the Toll-like receptors (TLRs) over the past 5 years has opened up an entirely new era in the understanding of the molecular events that initiate the inflammatory response. These ty...