Guidelines for Complications of Cancer Treatment Vol VIII Part B

oooWean steroids once vasopressors notrequired (2D) WHydrocortisone dose < 300 mg/day (1A) SDo not use steroids to treat sepsis in absence ofshock (1D) S 2004 C, E, A, E rhAPC (recombinant Human Activated Protein C)o Consider rhAPC in adult septic pts with high riskof death (APACHE II > 25 or MOF) if notcontraindicated (2B, 2C (for postoperativepatients).) Wo rhAPC should not be used for adult septic patientswith risk of death (APACHE II < 20 or one organfailure) (1A) S 2004 BOther supportive therapy of severe sepsis Blood product administrationo Give red blood cells when hemoglobin decreasesto 7.0 g/dL (70 g/L) to target a hemoglobin of 7.0–9.0 g/dL in adults A higher hemoglobin level maybe required in special circumstances (e.g.,myocardial ischaemia, severe hypoxemia, acutehemorrhage, cyanotic heart disease, or lacticacidosis) (1B).oo 2004 BDo not use erythropoietin to treat sepsis-relatedanemia. Erythropoietin may be used for otheraccepted reasons (1B)Do not use fresh frozen plasma to correctlaboratory clotting abnormalities unless there isbleeding or planned invasive procedures (2D)81