Editing Sepsis (section)

=== Other ===
Treating fever in sepsis, including people in septic shock, has not been associated with any improvement in mortality over a period of 28 days.<ref name=Drewry2017/> Treatment of fever still occurs for other reasons.<ref name=Niven2013/><ref name=Launey2011/>

A 2012 [[Cochrane Database of Systematic Reviews|Cochrane review]] concluded that [[N-acetylcysteine]] does not reduce mortality in those with SIRS or sepsis and may even be harmful.<ref name="Szakmany2012"/>

[[Recombinant DNA|Recombinant]] activated [[protein C]] ([[drotrecogin alpha]]) was originally introduced for severe sepsis (as identified by a high [[APACHE II]] score), where it was thought to confer a survival benefit.<ref name=Campaign2008 /> However, subsequent studies showed that it increased adverse events—bleeding risk in particular—and did not decrease mortality.<ref name=APC2012/> It was removed from sale in 2011.<ref name=APC2012 /> Another medication known as [[eritoran]] also has not shown benefit.<ref name=Fink2014/>

In those with [[hyperglycemia|high blood sugar]] levels, [[insulin]] to bring it down to 7.8–10&nbsp;mmol/L (140–180&nbsp;mg/dL) is recommended with lower levels potentially worsening outcomes.<ref name=Hirasawa2009/> Glucose levels taken from capillary blood should be interpreted with care because such measurements may not be accurate. If a person has an arterial catheter, arterial blood is recommended for blood glucose testing.<ref name= "SSC–G2016"/>

Intermittent or continuous [[renal replacement therapy]] may be used if indicated. However, [[sodium bicarbonate]] is not recommended for a person with lactic acidosis secondary to hypoperfusion. [[Low-molecular-weight heparin]] (LMWH), [[unfractionated heparin]] (UFH), and mechanical prophylaxis with [[intermittent pneumatic compression]] devices are recommended for any person with sepsis at moderate to high risk of [[venous thromboembolism]].<ref name= "SSC–G2016"/> Stress ulcer prevention with [[proton-pump inhibitor]] (PPI) and [[H2 antagonist]] are useful in a person with risk factors of developing [[upper gastrointestinal bleeding]] (UGIB) such as on mechanical ventilation for more than 48 hours, coagulation disorders, liver disease, and renal replacement therapy.<ref name= "SSC–G2016"/> Achieving partial or full enteral feeding (delivery of nutrients through a [[feeding tube]]) is chosen as the best approach to provide nutrition for a person who is contraindicated for oral intake or unable to tolerate orally in the first seven days of sepsis when compared to [[parenteral nutrition|intravenous nutrition]]. However, [[omega-3 fatty acid]]s are not recommended as immune supplements for a person with sepsis or septic shock. The usage of [[prokinetic agent]]s such as [[metoclopramide]], [[domperidone]], and [[erythromycin]] are recommended for those who are septic and unable to tolerate enteral feeding. However, these agents may precipitate prolongation of the [[QT interval]] and consequently provoke a [[ventricular arrhythmia]] such as [[torsades de pointes]]. The usage of prokinetic agents should be reassessed daily and stopped if no longer indicated.<ref name= "SSC–G2016"/>

People in sepsis may have micronutrient deficiencies, including low levels of vitamin C.<ref>{{cite journal | vauthors = Belsky JB, Wira CR, Jacob V, Sather JE, Lee PJ | title = A review of micronutrients in sepsis: the role of thiamine, L-carnitine, vitamin C, selenium and vitamin D | journal = Nutrition Research Reviews | volume = 31 | issue = 2 | pages = 281–90 | date = December 2018 | pmid = 29984680 | doi = 10.1017/S0954422418000124 | s2cid = 51599526 }}</ref> Reviews mention that an intake of 3.0 g/day, which requires intravenous administration, may be needed to maintain normal plasma concentrations in people with sepsis or severe burn injury.<ref name=Liang2023>{{cite journal |vauthors=Liang B, Su J, Shao H, Chen H, Xie B |title=The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials |journal=Crit Care |volume=27 |issue=1 |pages=109 |date=March 2023 |pmid=36915173 |pmc=10012592 |doi=10.1186/s13054-023-04392-y |url= | doi-access = free | title-link = doi }}</ref><ref>{{cite journal |vauthors=Berger MM, Oudemans-van Straaten HM |title=Vitamin C supplementation in the critically ill patient |journal=Curr Opin Clin Nutr Metab Care |volume=18 |issue=2 |pages=193–201 |date=March 2015 |pmid=25635594 |doi=10.1097/MCO.0000000000000148 |s2cid=37895257 |url=}}</ref>