Martin K, Weiss S L
Division of Critical Care Medicine, Department of Anesthesia and Critical Care, The Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA -
Minerva Pediatr. 2015 Apr;67(2):141-58. Epub 2015 Jan 21.
The pediatric sepsis syndrome remains a common cause of morbidity, mortality, and health care utilization costs worldwide. The initial resuscitation and management of pediatric sepsis is focused on 1) rapid recognition of abnormal tissue perfusion and restoration of adequate cardiovascular function; 2) eradication of the inciting invasive infection, including prompt administration of empiric broad-spectrum antimicrobial medications; and 3) supportive care of organ system dysfunction. Efforts to improve early and aggressive initial resuscitation and ongoing management strategies have improved outcomes in pediatric severe sepsis and septic shock, though many questions still remain as to the optimal therapeutic strategies for many patients. In this article, we will briefly review the definitions, epidemiology, clinical manifestations, and pathophysiology of sepsis and provide an extensive overview of both current and novel therapeutic strategies used to resuscitate and manage pediatric patients with severe sepsis and septic shock.
小儿脓毒症综合征仍是全球范围内发病、死亡以及医疗保健使用成本的常见原因。小儿脓毒症的初始复苏和管理集中于：1）快速识别异常的组织灌注并恢复足够的心血管功能；2）根除引发感染的侵袭性感染，包括及时给予经验性广谱抗菌药物；3）对器官系统功能障碍进行支持治疗。尽管对于许多患者的最佳治疗策略仍存在诸多问题，但改善早期积极初始复苏及持续管理策略的努力已使小儿严重脓毒症和脓毒性休克的治疗结果有所改善。在本文中，我们将简要回顾脓毒症的定义、流行病学、临床表现和病理生理学，并广泛概述用于复苏和管理小儿严重脓毒症和脓毒性休克患者的现有及新型治疗策略。
