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本文引用的文献

1
Low-dose hydrocortisone therapy attenuates septic shock in adult patients but does not reduce 28-day mortality: a meta-analysis of randomized controlled trials.小剂量氢化可的松治疗可减轻成年脓毒性休克患者的病情，但不能降低 28 天死亡率：一项随机对照试验的荟萃分析。
Anesth Analg. 2014 Feb;118(2):346-357. doi: 10.1213/ANE.0000000000000050.
2
Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care.儿科脓毒症研究的预后因素，来自西班牙小儿重症监护学会。
Pediatr Infect Dis J. 2014 Feb;33(2):152-7. doi: 10.1097/01.inf.0000435502.36996.72.
3
A systematic review and meta-analysis on the effect of steroids in pediatric shock.一项关于类固醇在小儿休克中作用的系统评价和荟萃分析。
Pediatr Crit Care Med. 2013 Jun;14(5):474-80. doi: 10.1097/PCC.0b013e31828a8125.
4
A survey of stated physician practices and beliefs on the use of steroids in pediatric fluid and/or vasoactive infusion-dependent shock.一项关于医师在小儿液体和/或血管活性输注依赖性休克中使用类固醇的实践和信念的调查。
Pediatr Crit Care Med. 2013 Jun;14(5):462-6. doi: 10.1097/PCC.0b013e31828a7287.
5
Salivary cortisol estimation to assess adrenal status in children with fluid unresponsive septic shock.评估液体无反应性脓毒性休克儿童肾上腺功能的唾液皮质醇测定。
Indian Pediatr. 2013 Jul;50(7):681-4. doi: 10.1007/s13312-013-0190-1. Epub 2012 Dec 5.
6
Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.拯救脓毒症运动：严重脓毒症和脓毒性休克管理国际指南，2012 年。
Intensive Care Med. 2013 Feb;39(2):165-228. doi: 10.1007/s00134-012-2769-8. Epub 2013 Jan 30.
7
The effects of three specific conditions related to critical care on adrenal function in children.三种特定的儿童重症监护相关条件对肾上腺功能的影响。
Intensive Care Med. 2012 Oct;38(10):1689-96. doi: 10.1007/s00134-012-2662-5. Epub 2012 Aug 10.
8
Salivary cortisol can replace free serum cortisol measurements in patients with septic shock.唾液皮质醇可替代脓毒性休克患者的游离血清皮质醇测量。
Chest. 2011 Nov;140(5):1216-1222. doi: 10.1378/chest.11-0448. Epub 2011 Aug 4.
9
Steroids for patients in septic shock: the results of the CORTICUS trial.皮质类固醇治疗感染性休克患者：CORTICUS 试验的结果。
CJEM. 2011 Jul;13(4):273-6. doi: 10.2310/8000.2011.110243.
10
A Single-Center Review of Prescribing Trends and Outcomes of Corticosteroid Replacement Therapy in Critically Ill Children with Septic Shock.对脓毒性休克重症患儿皮质类固醇替代疗法的处方趋势及疗效的单中心回顾
Open Crit Care Med J. 2010 Jan 1;3:51-56. doi: 10.2174/1874828701003010051.

小儿感染性休克中的相对肾上腺皮质功能不全

Relative Adrenal Insufficiency in Pediatric Septic Shock.

作者信息

Vila-Pérez David, Jordan-García Iolanda

机构信息

Pediatric Intensive Care Unit, Barcelona University, Hospital Sant Joan de Déu, Barcelona, Spain.

出版信息

J Pediatr Intensive Care. 2015 Sep;4(3):129-137. doi: 10.1055/s-0035-1559821. Epub 2015 Aug 7.

DOI:10.1055/s-0035-1559821
PMID:31110862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6513143/
Abstract

Sepsis and septic shock represent important causes of morbidity and mortality in children, and adrenal dysfunction may play a role in the cardiovascular and immunological response. According to existing reports, the incidence of adrenal dysfunction in critically ill children varies significantly between 4 and 52% of patients. This article reviews the concept of adrenal insufficiency and the role it may play in a pediatric septic shock. Also discussed are the diagnosis, prognosis, and treatment of adrenal insufficiency in septic shock in adults and children. Finally, the latest recommendations about steroid use in pediatric septic shock are summarized.

摘要

脓毒症和脓毒性休克是儿童发病和死亡的重要原因，肾上腺功能障碍可能在心血管和免疫反应中起作用。根据现有报告，危重症儿童肾上腺功能障碍的发生率在4%至52%的患者之间存在显著差异。本文综述了肾上腺功能不全的概念及其在儿童脓毒性休克中可能发挥的作用。还讨论了成人和儿童脓毒性休克中肾上腺功能不全的诊断、预后和治疗。最后，总结了关于儿童脓毒性休克中使用类固醇的最新建议。