NEW PERSPECTIVES ON THE MANAGEMENT OF SEPTIC SHOCK IN THE CANCER-PATIENT

Septic shock is a common life-threatening problem, usually presenting with fever, tachycardia, tachypnea, and often a source of infection. T he cardiac index is increased, with a decreased systemic vascular resi stance, and a reversibly decreased ejection fraction with an increased end diastolic volume. The myocardial depression is most likely caused by a circulating humoral substance that depresses myocardial contract ility. The initial treatment of septic shock is aggressive fluid resus citation and antibiotic therapy, with vasopressors and inotropes being indicated in those patients who do not respond adequately to fluids. Therapy directed against the mediators of;septic shock is theoreticall y promising, but to date has not been successful.