Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.
Intensive Care Med. 2016 Dec;42(12):1958-1969. doi: 10.1007/s00134-016-4577-z. Epub 2016 Oct 1.
Sepsis is a major growing global burden and a major challenge to intensive care clinicians, researchers, guideline committee members and policy makers, because of its high and increasing incidence and great pathophysiological, molecular, genetic and clinical complexity. In spite of recent progress, short-term mortality remains high and there is growing evidence of long-term morbidity and increased long-term mortality in survivors of sepsis both in developed and developing countries. Further improvement in the care of patients with sepsis will impact upon global health. In this narrative review, invited experts describe the expected challenges and progress to be made in the near future. We focus on diagnosis, resuscitation (fluids, vasopressors, inotropes, blood transfusion and hemodynamic targets) and infection (antibiotics and infection biomarkers), as these areas are key, if initial management and subsequent outcomes are to be improved in patients with sepsis.
脓毒症是一个日益严重的全球性负担，也是重症监护临床医生、研究人员、指南委员会成员和政策制定者面临的主要挑战，因为其发病率高且不断上升，且具有复杂的病理生理学、分子、遗传和临床特征。尽管最近取得了一些进展，但短期死亡率仍然很高，并且在发达国家和发展中国家，脓毒症幸存者的长期发病率和死亡率都在增加，这一现象有了更多的证据。进一步改善脓毒症患者的治疗将对全球健康产生影响。在这篇叙述性评论中，受邀的专家描述了在不久的将来预计会遇到的挑战和取得的进展。我们专注于诊断、复苏（液体、血管加压药、正性肌力药、输血和血流动力学目标）和感染（抗生素和感染生物标志物），因为这些领域是关键，如果要改善脓毒症患者的初始治疗和后续结果。
