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The Road Ahead

Jeremy M. Kahn, MD, MSc; David W. Bates, MD, MSc

JAMA. 2008;299(19):2322-2323.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In recent years there have been unprecedented advances in the understanding of the epidemiology, pathophysiology, and treatment of sepsis syndrome.^1-3 This work has culminated in several clinical trials demonstrating the efficacy of targeted interventions to improve sepsis-related outcomes.^4-6 These interventions include not only novel therapeutic agents such as drotrecogin alfa but also treatments directed at improving the way more traditional therapy is delivered, such as early resuscitation and low-tidal volume ventilation for acute lung injury.^4-6

Unfortunately the gaps between evidence and practice have long been huge.⁷ Indeed, most available data suggest that clinical trial and observational study results have not yet changed clinical practice in sepsis care. Few emergency departments have implemented protocols for early resuscitation of patients with severe sepsis, delayed and inappropriate antibiotic administration remains common, and many patients with acute lung injury receive mechanical ventilation with potentially . . . [Full Text of this Article]

Author Affiliations: Division of Pulmonary, Allergy and Critical Care and Center for Clinical Epidemiology and Biostatistics, School of Medicine, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Dr Kahn); and Division of General Internal Medicine and Center of Excellence for Patient Safety Research and Practice, Brigham and Women's Hospital and Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts (Dr Bates).

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