Maloney Patrick J
Department of Emergency Medicine, University of Colorado School of Medicine, Denver Health Medical Center, 660 Bannock Street, MC 0108, Denver, CO 80204, USA.
Emerg Med Clin North Am. 2013 Aug;31(3):583-600. doi: 10.1016/j.emc.2013.04.006. Epub 2013 Jul 10.
Early recognition of sepsis and septic shock in children relies on obtaining an attentive clinical history, accurate vital signs, and a physical examination focused on mental status, work of breathing, and circulatory status. Laboratory tests may support the diagnosis but are not reliable in isolation. The goal of septic shock management is reversal of tissue hypoperfusion. The therapeutic end point is shock reversal. Mortality is significantly better among children when managed appropriately. Every physician who cares for children must strive to have a high level of suspicion and keen clinical acumen for recognizing the rare but potentially seriously ill child.
儿童脓毒症和脓毒性休克的早期识别依赖于获取详尽的临床病史、准确的生命体征,以及针对精神状态、呼吸功能和循环状态的体格检查。实验室检查可能有助于诊断,但单独依靠它们并不可靠。脓毒性休克治疗的目标是逆转组织灌注不足。治疗终点是休克逆转。若治疗得当,儿童的死亡率会显著降低。每位照料儿童的医生都必须努力保持高度的怀疑态度和敏锐的临床洞察力,以识别出那些罕见但可能病情严重的儿童。