Department of Critical Care, St Thomas' Hospital, Westminster Bridge Rd., Lambeth, London, SE1 7EH, UK.
Crit Care. 2018 Sep 19;22(1):215. doi: 10.1186/s13054-018-2144-4.
Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mortality. Such patients are often poorly represented in large clinical trials. Consequently, good evidence for effective treatment strategies is lacking. In this article, we describe a pragmatic, multi-faceted approach to managing patients with refractory septic shock based on our experience of toxin-mediated sepsis in a specialist referral centre. Many components of this strategy are inexpensive and widely accessible, and so may offer an opportunity to improve outcomes in these critically ill patients.
尽管及时进行干预，仍有一小部分感染性休克患者会出现进行性多器官衰竭。这些患者对常规治疗似乎没有反应，死亡率非常高。这类患者在大型临床试验中往往代表性不足。因此，缺乏有效的治疗策略的充分证据。在本文中，我们根据在一家专科转诊中心对毒素介导性脓毒症的经验，描述了一种实用的、多方面的治疗难治性感染性休克患者的方法。该策略的许多组成部分都价格低廉且广泛可得，因此可能为改善这些重症患者的预后提供机会。
