Brunkhorst F M, Reinhart K
Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Jena der Friedrich-Schiller-Universität, Jena, Germany.
Chirurg. 2008 Apr;79(4):306-14. doi: 10.1007/s00104-008-1486-x.
Severe sepsis and septic shock have an increasing incidence and unchanged high mortality. Early diagnosis is necessary to slow the progression of organ dysfunction and improve outcome. Early administration of broad-spectrum antimicrobial therapy, early and aggressive hemodynamic therapy, and surgical source control are the most promising therapeutic approaches. Norepinephrine is the first choice as a vasopressor. Starches for volume resuscitation, intensive insulin therapy (aiming at 80-110 mg/dl), and low-dose hydrocortisone are not recommended outside randomized trials. Recombinant activated protein C is one choice for certain patients. The German Sepsis Competence Network (SepNet) is currently investigating other open questions.
严重脓毒症和脓毒性休克的发病率不断上升，死亡率居高不下。早期诊断对于减缓器官功能障碍的进展和改善预后至关重要。早期给予广谱抗菌治疗、早期积极的血流动力学治疗以及手术控制感染源是最有前景的治疗方法。去甲肾上腺素是血管升压药的首选。在随机试验之外，不推荐使用淀粉进行容量复苏、强化胰岛素治疗（目标为80 - 110mg/dl）和小剂量氢化可的松。重组活化蛋白C是某些患者的一种选择。德国脓毒症能力网络（SepNet）目前正在研究其他未解决的问题。
