Bughrara Nibras, Cha Stephanie, Safa Radwan, Pustavoitau Aliaksei
Department of Anesthesiology, Albany Medical College, 47 New Scotland Avenue, MC 131, Albany, NY 12208, USA; Department of Surgery, Albany Medical College, 47 New Scotland Avenue, MC 131, Albany, NY 12208, USA.
Division of Cardiothoracic Anesthesiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Suite 6216, Baltimore, MD 21287, USA; Division of Critical Care, Johns Hopkins University School of Medicine, 1800 Orleans Street, Suite 6216, Baltimore, MD 21287, USA.
Anesthesiol Clin. 2020 Mar;38(1):107-122. doi: 10.1016/j.anclin.2019.10.013. Epub 2020 Jan 2.
Sepsis and septic shock are medical emergencies, with high associated mortality. The Surviving Sepsis Campaign has developed definitions and management guidelines, emphasizing the use of hour-1 care bundle. Anesthesiologists frequently encounter sepsis when source control is required. The authors summarize expected manifestations of organ dysfunction and state-of-the-art management of patients with sepsis and septic shock. They highlight an increasingly vital role point-of-care ultrasound examination in the recognition and management of hemodynamic derangements in this patient population. Supporting the role of anesthesiologists as perioperative physicians, the authors provide a framework for transitions of care between operating room and intensive care units.
脓毒症和脓毒性休克是医疗急症,死亡率很高。拯救脓毒症运动制定了定义和管理指南,强调使用1小时护理集束。在需要进行源头控制时,麻醉医生经常会遇到脓毒症。作者总结了器官功能障碍的预期表现以及脓毒症和脓毒性休克患者的最新管理方法。他们强调了床旁超声检查在识别和管理该患者群体血流动力学紊乱方面日益重要的作用。为支持麻醉医生作为围手术期医生的角色,作者提供了手术室和重症监护病房之间护理过渡的框架。