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Invited Critique |

Molgramostim (GM-CSF) Associated With Antibiotic Treatment in Nontraumatic Abdominal Sepsis: A Randomized, Double-blind, Placebo-Controlled Clinical Trial—Invited Critique

Alden H. Harken, MD
Arch Surg. 2006;141(2):154. doi:10.1001/archsurg.141.2.154.
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Should we be surprised when your typical personal-injury lawyer fails to achieve a much-heralded ethical epiphany in response to a single dose of “church” on a Sunday morning? Although this credibility-defying analogy may seem far fetched, the critical care community has now been deluged with a thought-suppressing smorgasbord of prospective, randomized clinical trials in which a single dose (or 2) of cytokine antibody (or binding protein) is injected into an unfortunate postinjury patient in the throes of systemic inflammation. And Lazarus dies anyway. Is this akin to confronting the raging Chicago fire by seeking out and shooting Mrs O’Leary's cow? Or air-dropping a single flame jumper into the midst of a Yellowstone National Park fire? Do all these studies really mean that our natural host defenses cannot be manipulated therapeutically?

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