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[当前护理指南更新:脓毒症(成人)]

[Update on current care guideline: sepsis (adults].

作者信息

Ruokonen Esko, Hovilehto Seppo, Karlsson Sari, Loisa Pekka, Pettilä Ville, Rintala Esa, Sirola Joonas, Uusaro Ari

出版信息

Duodecim. 2014;130(5):516-7.

Abstract

The incidence of severe sepsis and septic shock requiring intensive care in Finnish adult population has increased to 0.60 11000 /y. Despite improved prognosis, hospital mortality related to severe sepsis and septic shock is high 24.1%. Key recommendations include prompt administration of antimicrobial therapy, optimally after blood cultures, quantitative fluid resuscitation and imaging studies to identify possible source of infection. Crystalloids are suitable for fluid resuscitation. Norepinephrine is the first-choice vasopressor in septic shock. Hydrocortisone should be considered only if fluid and vasopressor treatment does not restore hemodynamics.

摘要

在芬兰成年人群体中,需要重症监护的严重脓毒症和脓毒性休克的发病率已升至0.60/10000人/年。尽管预后有所改善,但与严重脓毒症和脓毒性休克相关的医院死亡率仍很高,为24.1%。关键建议包括及时给予抗菌治疗,最好在血培养后进行,进行定量液体复苏和影像学检查以确定可能的感染源。晶体液适合用于液体复苏。去甲肾上腺素是脓毒性休克的首选血管加压药。仅当液体和血管加压药治疗不能恢复血流动力学时才应考虑使用氢化可的松。

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