a. Anti-endotoxin
|
HA-1A | Anti-endotoxin antibody | ✓ | ✓ | × |
rBPI21 | Endotoxin binding and inactivation | ✓ | ✓ | ✓ |
| | | | Possible benefit |
LBP | Endotoxin binding protein | ✓ | | |
b. Leucocyte antagonists
|
Corticosteroids | | | ✓ | × |
| | | | Most studies show no significant benefit |
c. Anti-cytokine
|
Anti-TNFα antibody | TNFα blockade | ✓ | ✓ | × |
| | | | No benefit |
IL-1β receptor antagonist | IL-1β blockade | ✓ | ✓ | × |
| | | | No benefit |
d. Treatment of coagulopathy
|
Activated protein C | Replacement of protein C in an active form | ✓ | ✓ | |
| | | | Adult sepsis trial showed benefit |
Serum derived protein C (unactivated) | Replacement of depleted protein C | | ? | |
| | | May not be appropriate in unactivated form | |
Antithrombin | Replacement of depleted antithrombin | | ✓ | × |
| | | Risk of bleeding | No benefit |
Heparin | Anticoagulation, prevention of limb necrosis | | ✓ | |
| | | Risk of bleeding | |
Tissue plasminogen activator | Fibrinolysis, prevention of limb necrosis | | ✓ | |
| | | Risk of bleeding | |
e. Other
| | | | |
Haemodialysis/plasmapharesis | Cytokine removal | | ✓/× | |
| | | Some positive reports but not conclusive | |
Nitric oxide synthase inhibitors | Reduction of nitric oxide synthesis | ✓ | × | |
Extracorporeal membrane oxygenation | Treatment of ARDS | | ✓ | |