Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Curr Pharm Des. 2012;18(38):6298-307. doi: 10.2174/138161212803832263.
Septic shock during the perioperative period imparts significant challenges for anesthetic management. There is increasing support for standardization of care using evidence-based, international consensus guidelines, such as the Surviving Sepsis Campaign. This review will highlight practices in the supportive management relevant to the perioperative care of patients with severe sepsis or septic shock and their effect on clinical outcomes. It will address the epidemiological data of sepsis, the diagnostic criteria, and the role of routine, goal-directed hemodynamic resuscitation. Furthermore, it will review other options for support, including antibiotics, intensive insulin therapy, and intensive care sedation in this high risk patient population.
围手术期脓毒症休克给麻醉管理带来了重大挑战。越来越多的人支持使用循证、国际共识指南(如《拯救脓毒症运动》)来规范治疗。这篇综述将重点介绍与严重脓毒症或脓毒性休克患者围手术期护理相关的支持性治疗实践及其对临床结局的影响。它将讨论脓毒症的流行病学数据、诊断标准以及常规、目标导向的血流动力学复苏的作用。此外,它还将回顾在这一高危患者人群中支持治疗的其他选择,包括抗生素、强化胰岛素治疗和重症监护镇静。