Division of Pulmonary and Critical Care Medicine, University of Kansas, Kansas City, KS.
Chest. 2018 Jan;153(1):34-38. doi: 10.1016/j.chest.2017.10.006. Epub 2017 Oct 14.
Severe sepsis is a common, deadly, and diagnostically vexing condition. Recent recommendations for diagnosing sepsis, referred to as consensus guidelines, provide a definition of sepsis and remove the systemic inflammatory response syndrome (SIRS) as a component of the diagnostic process. A concise definition of sepsis is welcomed. However, the approach to developing these guidelines, although thorough, had weaknesses. Emphasis is placed on mortality prediction rather than on early diagnosis. Diagnostic criteria are recommended to replace current criteria without evidence of any effect that their use would have on mortality. SIRS is a prevalent feature of patients with sepsis, should remain an important component of the diagnostic process, and remains a valuable term for discussing patients with life-threatening organ dysfunction caused by infection.
严重脓毒症是一种常见且致命的疾病，其诊断也颇具挑战性。最近的脓毒症诊断建议，即所谓的共识指南，提供了脓毒症的定义，并将全身炎症反应综合征（SIRS）从诊断过程中去除。脓毒症的简明定义是受欢迎的。然而，制定这些指南的方法虽然全面，但存在弱点。重点放在死亡率预测上，而不是早期诊断上。推荐使用诊断标准来替代当前的标准，而没有证据表明其使用会对死亡率产生任何影响。SIRS 是脓毒症患者的普遍特征，应仍然是诊断过程中的一个重要组成部分，并且对于讨论因感染导致危及生命的器官功能障碍的患者来说仍然是一个有价值的术语。
