RT Journal
A1 Gosling P, Bascom JU, Zikria BA
T1 Systemic inflammatory response syndrome and magic bullets: Finding the target and improving the aim
JF Archives of Surgery
JO Archives of Surgery
YR 1998
FD March 1
VO 133
IS 3
SP 334
OP 334
DO 
UL http://dx.doi.org/
AB 
He correctly points out the shortcomings of trials of powerful modulators of inflammation in patients with a wide variety of diseases and disease severity, and recommends more critical patient selection for inclusion in therapeutic trials. This includes "rapidly identifying circulating endotoxin (by a lipopolysaccharide assay), Gram-negative bacteremia (by rapid culture techniques), and . . . elevated mediator levels, such as interleukin 6 or TNF [tumor necrosis factor]. . . ." However, because individual mediator levels change rapidly and have overlapping functions, even if rapid bedside patient measurement were possible, it may not identify those patients at risk of SIRS.