Department of Emergency Medicine, Clinical Hospital Sveti Duh, Zagreb, Croatia.
University Department for Anesthesiology, Resuscitation and Intensive Care, Clinical Hospital Sveti Duh, Zagreb, Croatia.
Acta Clin Croat. 2022 Jun;61(Suppl 1):67-72. doi: 10.20471/acc.2022.61.s1.11.
Sepsis is a life-threatening organ dysfunction caused by an unregulated response of a host. Septic shock is its most severe form. It is manifested by a drop in blood pressure, which decreases tissue perfusion pressure, causing hypoxia that is characteristic of shock. Sepsis is still one of the leading causes of mortality worldwide. Its incidence has increased since the first consensus definitions were established in 1991. Raising sepsis awareness, its significance and the need for better treatment, has led to an improvement in in defining sepsis and the development of guidelines for its treatment. The first guidelines were published in 2004, the second 2008, the third 2013, the fourth 2016, and the last revised guidelines appeared in 2021. This paper will describe the previous and new definitions of sepsis and septic shock, the previous guidelines for the recognition and treatment, and the latest recommendations for treatment. Timely diagnosis is crucial for the outcomes for patients with sepsis and septic shock. The fact is that the sepsis care bundles have been modified to increasingly shorter time determinants, which emphasizes the importance of emergency physicians, who frequently first recognize and begin emergency treatment of septic patients.
脓毒症是一种宿主失控的反应导致的危及生命的器官功能障碍。感染性休克是其最严重的形式。其表现为血压下降,降低组织灌注压,导致缺氧,这是休克的特征。脓毒症仍然是全球主要的死亡原因之一。自 1991 年首次确立共识定义以来,其发病率有所增加。提高对脓毒症的认识、其重要性以及对更好治疗的需求,导致了对脓毒症的定义的改进和治疗指南的制定。第一个指南于 2004 年发布,第二个于 2008 年,第三个于 2013 年,第四个于 2016 年,最近的修订版指南于 2021 年发布。本文将描述脓毒症和感染性休克的先前和新定义、以前的识别和治疗指南,以及最新的治疗建议。及时诊断对脓毒症和感染性休克患者的预后至关重要。事实上,脓毒症护理包已被修改为越来越短的时间决定因素,这强调了急诊医生的重要性,他们经常首先识别和开始对脓毒症患者进行紧急治疗。