Schlegel N
Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie, Universitätsklinik Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.
Chirurg. 2017 Jan;88(1):81-92. doi: 10.1007/s00104-016-0330-y.
Until a short time ago the criteria for sepsis were based on the assumption that sepsis is primarily caused by the inflammatory reaction of the body to an infection, which does not correspond to the current knowledge on the pathophysiology of sepsis. Accordingly, sepsis is now defined as a life-threatening organ dysfunction due to a falsely regulated response of the body to an infection. Septic shock occurs when a condition of persisting hypotension with the continuous need for vasopressor agents and serum lactate levels of >2 mmol/l despite administration of sufficient volume and fluid is present. These new definitions are discussed in this article with respect to the consequences for the diagnosis of sepsis. This review article also presents the current controversies on the most important aspects of the therapy of sepsis.
直到不久前，脓毒症的诊断标准还基于这样一种假设，即脓毒症主要是由身体对感染的炎症反应引起的，而这与目前关于脓毒症病理生理学的认识并不相符。因此，现在脓毒症被定义为由于身体对感染的调节反应失调而导致的危及生命的器官功能障碍。当出现持续低血压状态，尽管给予了足够的液体量但仍持续需要血管升压药物，且血清乳酸水平>2 mmol/L时，即为感染性休克。本文将就这些新定义对脓毒症诊断的影响进行讨论。这篇综述文章还介绍了目前在脓毒症治疗最重要方面存在的争议。
