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创伤诱导多器官功能衰竭的当前概念。

A current concept of trauma-induced multiorgan failure.

作者信息

Lee C C, Marill K A, Carter W A, Crupi R S

机构信息

Department of Emergency Medicine, Flushing Hospital Medical Center, 45th Avenue at Parsons Boulevard, Flushing, NY 11355, USA.

出版信息

Ann Emerg Med. 2001 Aug;38(2):170-6. doi: 10.1067/mem.2001.114313.

Abstract

Trauma deaths continue to show a trimodal distribution: immediately at the scene, within the first 24 hours during initial resuscitation, and in the next 3 to 4 weeks as a result of multiple organ failure.(1) Failure to resuscitate adequately in the emergency department can lead to acidosis, hypothermia, and coagulopathy, which can result in multiple organ failure and cause death in these patients. Our current understanding of the initial response to shock and trauma and the development of the systemic inflammatory response syndrome and progressive organ failure is one of a continuum initiated and perpetuated by inflammation and inflammatory mediators. The pathophysiologic character, diagnosis, prevention, and treatment of traumatic injury-induced multiple organ failure are discussed.

摘要

创伤死亡仍呈现三峰分布

当场即刻死亡、在初始复苏的头24小时内死亡、以及在接下来3至4周内因多器官功能衰竭而死亡。(1)在急诊科未能充分复苏可导致酸中毒、体温过低和凝血病,进而可导致多器官功能衰竭并致使这些患者死亡。我们目前对休克和创伤初始反应以及全身炎症反应综合征和进行性器官衰竭发展的理解是,这是一个由炎症和炎症介质引发并持续存在的连续过程。本文讨论了创伤性损伤所致多器官功能衰竭的病理生理特征、诊断、预防和治疗。

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