Kawasaki Tatsuya
Department of Pediatric Critical Care, Shizuoka Children's Hospital, 860 Ursuhiyama, Aoi-ku, Shizuoka, Shizuoka 420-8660 Japan.
J Intensive Care. 2017 Jul 20;5:47. doi: 10.1186/s40560-017-0240-1. eCollection 2017.
Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012.
New knowledge was added regarding the hemodynamic management and the timely use of antimicrobials. Quality improvement initiatives of pediatric "sepsis bundles" were reported to be successful in clinical outcomes by several centers. Moreover, a recently published global epidemiologic study (the SPROUT study) did not only reveal the demographics, therapeutic interventions, and prognostic outcomes but also elucidated the inappropriateness of the current definition of pediatric sepsis.
With these updated knowledge, the management of pediatric sepsis would be expected to make further progress. In addition, it is meaningful that the fundamental data on which future research should be based were established through the SPROUT study.
脓毒症是全球儿童死亡的主要原因之一。然而，遗憾的是，小儿脓毒症的可靠证据不足，临床实践中的许多方面实际上依赖于专家共识以及成人脓毒症的一些证据。自2012年《拯救脓毒症运动指南》发布以来，最新研究结果让我们对小儿脓毒症有了更深入的了解。
关于血流动力学管理和抗菌药物的及时使用有了新的认识。几个中心报告称，儿科“脓毒症集束治疗”的质量改进措施在临床结果方面取得了成功。此外，最近发表的一项全球流行病学研究（SPROUT研究）不仅揭示了人口统计学、治疗干预措施和预后结果，还阐明了当前小儿脓毒症定义的不恰当之处。
有了这些更新的知识，小儿脓毒症的管理有望取得进一步进展。此外，通过SPROUT研究建立了未来研究应基于的基础数据，这很有意义。
