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[严重脓毒症中心血管衰竭的早期识别与治疗]

[Early identification and treatment of cardiovascular failure in severe sepsis].

作者信息

Haase Nicolai, White Jonathan, Perner Anders

机构信息

Intensiv Terapiklinik 4131, Rigshospitalet, Blegdamsvej 9, DK-2100 København Ø, Denmark.

出版信息

Ugeskr Laeger. 2010 Jan 18;172(3):210-4.

Abstract

Severe sepsis is a leading cause of death characterised by infection-induced endothelial and cardiac dysfunction leading to hypovolaemia, maldistribution of flow, tissue ischaemia and organ failure. A clinical approach with focus on cardiovascular diagnostics and rational goal-directed therapy is likely to reduce the high mortality. The treatment involves focus control, broad-spectrum antibiotics, target-oriented fluid therapy and vasopressor and inotropic agents guided by frequent reassessments of the patient's response to treatment.

摘要

严重脓毒症是主要的死亡原因,其特征为感染诱发的内皮功能和心脏功能障碍,进而导致血容量减少、血流分布不均、组织缺血和器官衰竭。一种侧重于心血管诊断和合理的目标导向治疗的临床方法可能会降低高死亡率。治疗包括病灶控制、广谱抗生素、目标导向性液体治疗以及血管加压药和正性肌力药物,治疗过程中需频繁重新评估患者对治疗的反应并据此进行调整。

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