RESOLVE-ing sepsis in children – not yet! 英文参考文献.docVIP

Available online /content/11/3/138 Commentary RESOLVE-ing sepsis in children – not yet! Simon Nadel Paediatric Intensive Care, St Mary’s Hospital and Imperial College, London W2 1NY, UK Corresponding author: Simon Nadel, s.nadel@imperial.ac.uk Published: 8 June 2007 Critical Care 2007, 11:138 (doi:10.1186/cc5919) This article is online at /content/11/3/138 ? 2007 BioMed Central Ltd Abstract The RESOLVE study failed to find any clear benefit for the use of DrotAA in children with severe sepsis in the study population as a whole, or in any specific subgroup, either previously defined or after post-hoc analysis. The RESOLVE study did, however, produce some important findings. It was the largest study ever performed in children with severe sepsis, and thus helped to define both the natural history of The Researching Severe Sepsis and Organ Dysfunction in Children: A Global Perspective study of drotrecogin alfa activated versus placebo was the largest study of adjunctive therapy ever performed in children with severe sepsis. Despite this, the study failed to show any significant differences in outcome between the treatment and placebo groups. The results raise questions about how we should perform meaningful clinical trials in relatively rare conditions such as paediatric sepsis, where the easily measurable endpoints (such as death) are infrequent. A radical rethink of the design of such studies is urgently needed. sepsis in children and the incidence of important complications such as sepsis-induced organ failure and bleeding events. In the RESOLVE study, patients with the most severe coagulation abnormalities appeared to benefit most from DrotAA, suggesting this group of patients may be a valuable population for further study. In addition, intracranial bleeding events were more common with DrotAA than with placebo (five even