Crit Care Med. 1999 Mar;27(3):639-60. doi: 10.1097/00003246-199903000-00049.
To present guidelines for hemodynamic support of adult patients with sepsis.
An international task force of nine experts in disciplines related to critical care medicine was convened from the membership of the Society of Critical Care Medicine.
Review of published literature and expertise and personal experience of task force. The strength of evidence of human studies was classified according to study design and scientific value.
The task force met several times in person and communicated by electronic mail to identify the pertinent literature and arrive at consensus recommendations. Consideration was given to the relationship between the weight of scientific evidence and the experts'opinions. Draft documents were composed and debated by the task force until consensus was reached. The strength of recommendations was graded according to evidenced-based guidelines.
The panel formulated an underlying approach to the hemodynamic support of sepsis. Hemodynamic therapies should be titrated to specific and definable endpoints. The effects of therapy should be assessed by monitoring a combination of parameters of global and regional perfusion. Using this approach, the panel made specific recommendations for fluid resuscitation, vasopressor therapy, and inotropic therapy of septic patients.
提出成人脓毒症患者血流动力学支持的指南。
从危重病医学会成员中召集了一个由9名危重病医学相关学科专家组成的国际特别工作组。
对已发表文献以及特别工作组的专业知识和个人经验进行回顾。根据研究设计和科学价值对人体研究的证据强度进行分类。
特别工作组多次亲自会面并通过电子邮件进行沟通，以确定相关文献并达成共识性建议。考虑了科学证据的权重与专家意见之间的关系。特别工作组撰写并讨论了文件草案，直至达成共识。根据循证指南对建议的强度进行分级。
该小组制定了脓毒症血流动力学支持的基本方法。血流动力学治疗应根据特定且可定义的终点进行滴定。应通过监测整体和局部灌注的参数组合来评估治疗效果。采用这种方法，该小组对脓毒症患者的液体复苏、血管升压药治疗和正性肌力药治疗提出了具体建议。
