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Semin Respir Crit Care Med. 2010 Feb;31(1):66-78. doi: 10.1055/s-0029-1246290. Epub 2010 Jan 25.

Controversies in the treatment of sepsis.

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  • 1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Clinical Medicine, University of California Davis School of Medicine, Sacramento, CA95817, USA.


Sepsis is a common illness of intensive care unit patients that carries a high morbidity, mortality, and increases hospital cost. Although mortality from sepsis remains high when compared with other critical illnesses, it has declined over the last few decades due to several adjunctive therapies and focused care programs or guidelines. Many interventions, such as early appropriate antibiotic therapy and lung protective, low tidal volume ventilation are commonplace and carry little controversy in their benefit. However, other therapies still have an unclear benefit and remain controversial. This article discusses the controversial roles of intensive insulin therapy, corticosteroids, and activated protein C in the treatment of sepsis.

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