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严重脓毒症患者感染管理的最新进展

Update on the management of infection in patients with severe sepsis.

作者信息

Vandijck Dominique M, Blot Stijn I, Decruyenaere Johan M

机构信息

Department of Intensive Care Medicine, Faculty of Medicine and Health Sciences, Ghent University-Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.

出版信息

Dimens Crit Care Nurs. 2008 Nov-Dec;27(6):244-8. doi: 10.1097/01.DCC.0000338868.31917.0e.

Abstract

Morbidity and mortality associated with the development of severe sepsis remain unacceptably high. However, with the introduction of a protocol called early goal-directed therapy, significant benefits in terms of patient's outcome have been demonstrated. In an aim to improve outcome and to increase awareness, practical evidence-based guidelines for the management of severe sepsis and septic shock were developed under the auspices of the Sepsis Surviving Campaign, easy to apply by the bedside medical and nursing staff. The treatment of severe sepsis includes 3 main essentials: (1) eradication of the inciting infection using source control measures and empiric antimicrobials, (2) hemodynamic resuscitation of tissue hypoperfusion using fluids and inotropic drugs to prevent life-threatening organ damage, and (3) sustained organ support using mechanical interventions to diminish organ injury. This review article highlights the anti-infective approach of the management of sepsis.

摘要

与严重脓毒症发展相关的发病率和死亡率仍然高得令人无法接受。然而,随着一种名为早期目标导向治疗方案的引入,已证明在患者预后方面有显著益处。为了改善预后并提高认识,在脓毒症存活运动的支持下制定了实用的循证严重脓毒症和感染性休克管理指南,便于床边医护人员应用。严重脓毒症的治疗包括三个主要要点:(1)使用源头控制措施和经验性抗菌药物根除诱发感染;(2)使用液体和血管活性药物对组织灌注不足进行血流动力学复苏,以防止危及生命的器官损害;(3)使用机械干预措施进行持续的器官支持,以减轻器官损伤。这篇综述文章重点介绍了脓毒症管理中的抗感染方法。

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