Department of Anaesthesia and Intensive Care, IRCCS Istituto Clinico Humanitas, Humanitas University, Milan, Italy.
NYU School of Medicine, Bellevue Hospital Center, New York, NY, USA.
Lancet. 2018 Jul 7;392(10141):75-87. doi: 10.1016/S0140-6736(18)30696-2. Epub 2018 Jun 21.
Sepsis is a common condition that is associated with unacceptably high mortality and, for many of those who survive, long-term morbidity. Increased awareness of the condition resulting from ongoing campaigns and the evidence arising from research in the past 10 years have increased understanding of this problem among clinicians and lay people, and have led to improved outcomes. The World Health Assembly and WHO made sepsis a global health priority in 2017 and have adopted a resolution to improve the prevention, diagnosis, and management of sepsis. In 2016, a new definition of sepsis (Sepsis-3) was developed. Sepsis is now defined as infection with organ dysfunction. This definition codifies organ dysfunction using the Sequential Organ Failure Assessment score. Ongoing research aims to improve definition of patient populations to allow for individualised management strategies matched to a patient's molecular and biochemical profile. The search continues for improved diagnostic techniques that can facilitate this aim, and for a pharmacological agent that can improve outcomes by modifying the disease process. While waiting for this goal to be achieved, improved basic care driven by education and quality-improvement programmes offers the best hope of increasing favourable outcomes.
脓毒症是一种常见病症，其死亡率高得令人无法接受，许多存活下来的患者还伴有长期的发病。由于过去 10 年中持续开展的宣传活动和研究取得的证据，临床医生和普通大众对这种病症的认识有所提高，从而改善了治疗效果。世界卫生大会和世卫组织于 2017 年将脓毒症作为全球卫生重点，并通过了一项决议，以改善脓毒症的预防、诊断和管理。2016 年，制定了脓毒症的新定义（Sepsis-3）。现在，脓毒症被定义为感染导致的器官功能障碍。这一定义使用序贯性器官衰竭评估评分来规范器官功能障碍。目前正在进行的研究旨在改善患者人群的定义，以便根据患者的分子和生化特征制定个体化的管理策略。研究人员正在继续寻找改进的诊断技术，以实现这一目标，并寻找一种能够通过改变疾病过程来改善预后的药物。在等待这一目标实现的同时，通过教育和质量改进计划来改善基本护理，为提高有利的治疗效果提供了最大的希望。
