Other supportive therapies in sepsis.

Patients who survive the circulatory and organ deficits in sepsis may still fall victim to complications such as pulmonary embolism and stress ulcer bleeding. Although there is no clearcut evidence to quantitate the impact of such complications on mortality, the anticipated impact is grave when considering the compromised physiological reserve of these patients. For this reason it is important to institute effective prophylaxis to minimize the impact. In addition, catabolism associated with sepsis likely influences the recovery of patients with sepsis and moreover can compromise the response of the immune system against an infectious insult. Early and adequate nutritional support therefore appears important. There is much controversy and lack of prospective research regarding effect of supportive therapies on outcome in patients with severe sepsis. This research is needed.