Vidrine Rhea, Atreya Mihir R, Stalets Erika L
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Transl Pediatr. 2018 Oct;7(4):253-261. doi: 10.21037/tp.2018.10.01.
Sepsis is a burdensome public health problem and a leading cause of infant and child morbidity and mortality across the world. Few proven therapies exist to treat septic shock and the mainstay of management remains judicious fluid resuscitation and timely antibiotics. In its most recent iteration, the American College of Critical Care Medicine (ACCM) guidelines on hemodynamic support in pediatric septic shock recommends an institutional approach to the management of septic shock rather than one aimed at the individual practitioner. The acute care delivery model has been proposed as a way to guide quality improvement in emergency care and to improve care delivery. In this review, we summarize current recommendations in the management of pediatric patients with septic shock, and highlight opportunities to provide seamless care by application of the acute care model.
脓毒症是一个沉重的公共卫生问题，也是全球婴幼儿发病和死亡的主要原因。治疗感染性休克的有效疗法很少，主要治疗手段仍然是审慎的液体复苏和及时使用抗生素。美国危重病医学会（ACCM）最新版的小儿感染性休克血流动力学支持指南建议采用机构性方法来管理感染性休克，而非针对个体从业者。急性医疗服务模式已被提议作为指导急诊医疗质量改进和改善医疗服务的一种方式。在本综述中，我们总结了小儿感染性休克管理的当前建议，并强调了通过应用急性医疗模式提供无缝护理的机会。
