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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite efforts to establish uniform protocols for the management of severe sepsis&#44; this condition continues to have high morbidity and mortality&#46; This is due&#44; among other factors&#44; to the many barriers for the development of the protocols and the application time&#46; That is why new therapeutic measures are continuing to be investigated and developed&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To review the literature on the new and future therapeutic alternatives available in the management of sepsis in critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle">Data source and search method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A search was made for articles consistent with evidence-based medicine guidelines published between 2004 and 2009 in different databases &#40;Cochrane Plus Library&#44; National Guideline Clearinghouse&#44; Clinical Evidence&#44; REMI and PubMed&#41; and the NIH Clinical Trails database &#40;ClinicalTrials&#46;gov&#41; using the TRIP meta-search engine&#46;</p> <span class="elsevierStyleSectionTitle">Study selection</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 357 documents were retrieved&#44; selecting 48 of which included systematic reviews&#44; meta-analyses&#44; clinical practice guidelines&#44; structured abstracts of original articles&#44; and clinical trials&#46; The selection criteria followed the peer review process&#46;</p> <span class="elsevierStyleSectionTitle">Data extraction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Data were extracted by two independent reviewers&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Based on the 2004&#8211;2009 study period&#44; sufficient evidence was not obtained to make further recommendations on the treatment of sepsis&#46; Although the abundant evidence needed to suggest the utility of these therapeutic measures&#44; inhaled nitric oxide&#44; statins&#44; and immunoglobulins are probably good options for the adjuvant treatment of sepsis&#46; However&#44; we must wait for the results of different ongoing clinical trials on new treatment modalities&#46; Stem cells and gene therapy will probably emerge as novel therapies in the future&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La sepsis grave sigue teniendo elevadas morbilidad y mortalidad&#44; a pesar de los esfuerzos realizados en la instauraci&#243;n de protocolos uniformes de actuaci&#243;n&#44; debido&#44; entre otros muchos factores&#44; a la existencia de m&#250;ltiples barreras para la implantaci&#243;n&#44; as&#237; como su tiempo de aplicaci&#243;n&#46; Es por ello que se sigue desarrollando e investigando sobre nuevas medidas terap&#233;uticas&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Realizar una revisi&#243;n de la literatura sobre las nuevas y futuras alternativas terap&#233;uticas de que disponemos para el tratamiento de la sepsis en los pacientes cr&#237;ticos&#46;</p> <span class="elsevierStyleSectionTitle">Fuentes de datos y m&#233;todo de b&#250;squeda</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se llevo a cabo una b&#250;squeda limitada por tiempo desde 2004 hasta 2009&#44; a trav&#233;s del metabuscador Trip Database en las p&#225;ginas de medicina basada en la evidencia &#40;Cochrane Plus&#44; National Guideline Clearinghouse&#44; Clinical Evidence&#44; REMI y PubMed&#41; y base de datos de ensayos cl&#237;nicos &#40;ClinicalTrials&#46;gov&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Selecci&#243;n de los estudios</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron de la b&#250;squeda 357 documentos&#44; de los cuales se seleccionaron 48 que incluyen revisiones sistem&#225;ticas&#44; metaan&#225;lisis&#44; gu&#237;as de pr&#225;ctica cl&#237;nica&#44; res&#250;menes estructurados de un art&#237;culo original y ensayos cl&#237;nicos&#46; El m&#233;todo empleado para aplicar estos criterios se hizo mediante una revisi&#243;n por pares&#46;</p> <span class="elsevierStyleSectionTitle">Extracci&#243;n de datos</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Un posterior an&#225;lisis por dos revisores independientes&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">En el periodo de estudio 2004&#8211;2009 no ha habido aportaciones con evidencia suficiente como para realizar nuevas recomendaciones en el tratamiento de la sepsis&#46; Aunque no se aporta la abundante evidencia que se&#241;ale la utilidad de estas medidas terap&#233;uticas&#44; probablemente el &#243;xido n&#237;trico inhalado&#44; las estatinas y las inmunoglobulinas sean buenas alternativas en el tratamiento adyuvante de la sepsis&#46; Tendremos que esperar&#44; de todas maneras&#44; los resultados de los diferentes ensayos cl&#237;nicos que se encuentran en marcha sobre las nuevas terapias&#46; El futuro posiblemente podr&#237;a estar en las c&#233;lulas madre y la genoterapia&#46;</p>"
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New therapeutic alternatives for severe sepsis in the critical patient. A review
Nuevas alternativas terapéuticas para la sepsis grave en el paciente crítico. Revisión
A. Loza Vázqueza,
Corresponding author
aloza@telefonica.net

Corresponding author.
, C. León Gila, A. León Regidorb
a Servicio de Medicina Intensiva, Hospital Universitario de Valme, Sevilla, Spain
b Servicio de Medicina Intensiva, Hospital General de Catalunya, Barcelona, Spain
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    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Nuevas alternativas terap&#233;uticas para la sepsis grave en el paciente cr&#237;tico&#46; Revisi&#243;n"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2010-05-01"
    "fechaAceptado" => "2010-10-25"
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      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec10636"
          "palabras" => array:3 [
            0 => "New therapies"
            1 => "Sepsis"
            2 => "Critically ill patient"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
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          "palabras" => array:3 [
            0 => "Nuevas terapias"
            1 => "Sepsis"
            2 => "Paciente cr&#237;tico"
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    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite efforts to establish uniform protocols for the management of severe sepsis&#44; this condition continues to have high morbidity and mortality&#46; This is due&#44; among other factors&#44; to the many barriers for the development of the protocols and the application time&#46; That is why new therapeutic measures are continuing to be investigated and developed&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To review the literature on the new and future therapeutic alternatives available in the management of sepsis in critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle">Data source and search method</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A search was made for articles consistent with evidence-based medicine guidelines published between 2004 and 2009 in different databases &#40;Cochrane Plus Library&#44; National Guideline Clearinghouse&#44; Clinical Evidence&#44; REMI and PubMed&#41; and the NIH Clinical Trails database &#40;ClinicalTrials&#46;gov&#41; using the TRIP meta-search engine&#46;</p> <span class="elsevierStyleSectionTitle">Study selection</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 357 documents were retrieved&#44; selecting 48 of which included systematic reviews&#44; meta-analyses&#44; clinical practice guidelines&#44; structured abstracts of original articles&#44; and clinical trials&#46; The selection criteria followed the peer review process&#46;</p> <span class="elsevierStyleSectionTitle">Data extraction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Data were extracted by two independent reviewers&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Based on the 2004&#8211;2009 study period&#44; sufficient evidence was not obtained to make further recommendations on the treatment of sepsis&#46; Although the abundant evidence needed to suggest the utility of these therapeutic measures&#44; inhaled nitric oxide&#44; statins&#44; and immunoglobulins are probably good options for the adjuvant treatment of sepsis&#46; However&#44; we must wait for the results of different ongoing clinical trials on new treatment modalities&#46; Stem cells and gene therapy will probably emerge as novel therapies in the future&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La sepsis grave sigue teniendo elevadas morbilidad y mortalidad&#44; a pesar de los esfuerzos realizados en la instauraci&#243;n de protocolos uniformes de actuaci&#243;n&#44; debido&#44; entre otros muchos factores&#44; a la existencia de m&#250;ltiples barreras para la implantaci&#243;n&#44; as&#237; como su tiempo de aplicaci&#243;n&#46; Es por ello que se sigue desarrollando e investigando sobre nuevas medidas terap&#233;uticas&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Realizar una revisi&#243;n de la literatura sobre las nuevas y futuras alternativas terap&#233;uticas de que disponemos para el tratamiento de la sepsis en los pacientes cr&#237;ticos&#46;</p> <span class="elsevierStyleSectionTitle">Fuentes de datos y m&#233;todo de b&#250;squeda</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se llevo a cabo una b&#250;squeda limitada por tiempo desde 2004 hasta 2009&#44; a trav&#233;s del metabuscador Trip Database en las p&#225;ginas de medicina basada en la evidencia &#40;Cochrane Plus&#44; National Guideline Clearinghouse&#44; Clinical Evidence&#44; REMI y PubMed&#41; y base de datos de ensayos cl&#237;nicos &#40;ClinicalTrials&#46;gov&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Selecci&#243;n de los estudios</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se obtuvieron de la b&#250;squeda 357 documentos&#44; de los cuales se seleccionaron 48 que incluyen revisiones sistem&#225;ticas&#44; metaan&#225;lisis&#44; gu&#237;as de pr&#225;ctica cl&#237;nica&#44; res&#250;menes estructurados de un art&#237;culo original y ensayos cl&#237;nicos&#46; El m&#233;todo empleado para aplicar estos criterios se hizo mediante una revisi&#243;n por pares&#46;</p> <span class="elsevierStyleSectionTitle">Extracci&#243;n de datos</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Un posterior an&#225;lisis por dos revisores independientes&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">En el periodo de estudio 2004&#8211;2009 no ha habido aportaciones con evidencia suficiente como para realizar nuevas recomendaciones en el tratamiento de la sepsis&#46; Aunque no se aporta la abundante evidencia que se&#241;ale la utilidad de estas medidas terap&#233;uticas&#44; probablemente el &#243;xido n&#237;trico inhalado&#44; las estatinas y las inmunoglobulinas sean buenas alternativas en el tratamiento adyuvante de la sepsis&#46; Tendremos que esperar&#44; de todas maneras&#44; los resultados de los diferentes ensayos cl&#237;nicos que se encuentran en marcha sobre las nuevas terapias&#46; El futuro posiblemente podr&#237;a estar en las c&#233;lulas madre y la genoterapia&#46;</p>"
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    ]
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">These data were presented in part at the XXXI Congress of the Sociedad Andaluza de Medicina Intensiva&#44; Urgencias y Coronarias &#40;SAMIUC&#41;&#46; M&#225;laga&#44; 12-14 November 2009&#46;</p>"
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      "titulo" => "References"
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