Ellender Timothy, Benzoni Nicole
Department of Emergency Medicine, Indiana University, 1701 North Senate Avenue, Indianapolis, IN 46202, USA.
Department of Emergency Medicine, Indiana University, 1701 North Senate Avenue, Indianapolis, IN 46202, USA.
Emerg Med Clin North Am. 2020 Nov;38(4):807-818. doi: 10.1016/j.emc.2020.06.006.
Sepsis care has evolved significantly since the initial early goal-directed therapy (EGDT) trials. Early fluid resuscitation, source control, and antibiotic therapy remain cornerstones of care but overall understanding is more nuanced, particularly regarding fluid selection, vasopressors, and inotropic support. Timely nutrition therapy and ventilatory support tend to receive less attention but also are important. Recent research has explored immunomodulation, β-blockade, and vitamin supplementation. A renewed emphasis on early, aggressive resuscitation reaffirms the importance of emergency medicine providers knowledgeable and skilled in sepsis management.
自最初的早期目标导向治疗(EGDT)试验以来,脓毒症的治疗已发生了显著演变。早期液体复苏、源头控制和抗生素治疗仍然是治疗的基石,但总体认识更为细致入微,特别是在液体选择、血管升压药和正性肌力支持方面。及时的营养治疗和通气支持往往受到较少关注,但也很重要。最近的研究探讨了免疫调节、β受体阻滞剂和维生素补充。重新强调早期积极复苏再次确认了急诊医学提供者在脓毒症管理方面知识渊博且技能娴熟的重要性。