Yuki Koichi, Murakami Naoka
Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts, 02115, USA.
Cardiovasc Hematol Disord Drug Targets. 2015;15(1):57-69. doi: 10.2174/1871529x15666150108114810.
Sepsis remains to be a significant health care issue associated with high mortality and healthcare cost, despite the extensive effort to better understand the pathophysiology of the sepsis. Recently updated clinical guideline for severe sepsis and septic shock, "Surviving Sepsis Campaign 2012", emphasizes the importance of early goal-directed therapy, which can be implemented in intraoperative management of sepsis patients. Herein, we review the updates of current guideline and discuss its application to anesthesic management. Furthermore, we review the recent advance in knowledge of sepsis pathophysiology, focusing on immune modulation, which may lead to new clinical therapeutic approach to sepsis.
尽管人们为更好地理解脓毒症的病理生理学付出了巨大努力，但脓毒症仍然是一个与高死亡率和医疗成本相关的重大医疗保健问题。最近更新的关于严重脓毒症和脓毒性休克的临床指南《2012拯救脓毒症运动》强调了早期目标导向治疗的重要性，该治疗可在脓毒症患者的术中管理中实施。在此，我们回顾当前指南的更新内容，并讨论其在麻醉管理中的应用。此外，我们回顾脓毒症病理生理学知识的最新进展，重点关注免疫调节，这可能会带来脓毒症新的临床治疗方法。
