Raghavan Murugan, Marik Paul E
Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Emerg Med. 2006 Aug;31(2):185-99. doi: 10.1016/j.jemermed.2006.05.008.
Severe sepsis and septic shock are common causes of morbidity and mortality. Interventions directed at specific endpoints, when initiated early in the "golden hours" of patient arrival at the hospital, seem to be promising. Early hemodynamic optimization, administration of appropriate antimicrobial therapy, and effective source control of infection are the cornerstones of successful management. In patients with vasopressor-dependent septic shock, provision of physiologic doses of replacement steroids may result in improved survival. Administration of drotrecogin alfa (activated), (activated protein C) has been shown to improve survival in patients with severe sepsis and septic shock who have a high risk of mortality. In this article we review the multi-modality approach to early diagnosis and intervention in the therapy of patients with severe sepsis and septic shock.
严重脓毒症和脓毒性休克是发病和死亡的常见原因。在患者入院后的“黄金时段”早期启动针对特定终点的干预措施，似乎很有前景。早期血流动力学优化、给予适当的抗菌治疗以及有效控制感染源是成功治疗的基石。对于依赖血管升压药的脓毒性休克患者，给予生理剂量的补充类固醇可能会提高生存率。已证明给予重组人活化蛋白C（drotrecogin alfa）可提高严重脓毒症和脓毒性休克且死亡风险高的患者的生存率。在本文中，我们回顾了严重脓毒症和脓毒性休克患者早期诊断和治疗的多模式方法。
