Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
St. George's Healthcare NHS Trust, St George's University of London, London, UK.
Intensive Care Med. 2017 Apr;43(4):496-508. doi: 10.1007/s00134-017-4677-4. Epub 2017 Jan 27.
Because of its high incidence and clinical complexity, sepsis is a major challenge to clinicians and researchers and a global burden to healthcare systems and society. Despite recent progress, short- and long-term morbidity, mortality and costs remain high in both developed and developing countries. Thus, further improvements in supportive interventions and organisation of care are likely to have a substantial impact upon global health. In this narrative review, invited experts describe the challenges and progress to be made in sepsis research and care in the near future. We focus on supportive care (pulmonary, endocrine, renal, and nutritional support, mediator modulation and precision medicine), organisational themes (guidelines, outcome measures and stakeholder involvement) and clinical research as key areas to improving the care and outcomes of patients with sepsis.
由于其高发病率和临床复杂性,脓毒症是临床医生和研究人员面临的主要挑战,也是医疗保健系统和社会的全球性负担。尽管最近取得了进展,但在发达国家和发展中国家,短期和长期发病率、死亡率和成本仍然很高。因此,进一步改善支持性干预措施和护理组织可能会对全球健康产生重大影响。在这篇叙述性评论中,受邀专家描述了未来脓毒症研究和护理方面的挑战和进展。我们专注于支持性护理(肺部、内分泌、肾脏和营养支持、介质调节和精准医学)、组织主题(指南、结果测量和利益相关者参与)以及临床研究,作为改善脓毒症患者护理和结局的关键领域。