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你会如何抢救这位感染性休克患者?:贝斯以色列女执事医疗中心的大查房讨论

How Would You Resuscitate This Patient With Septic Shock? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

作者信息

Kanjee Zahir, Berg Katherine, Bell Taison D, Reynolds Eileen E

机构信息

Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Z.K., E.E.R.).

Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.B.).

出版信息

Ann Intern Med. 2023 Feb;176(2):253-259. doi: 10.7326/M22-3385. Epub 2023 Feb 14.

Abstract

Sepsis is a potentially life-threatening systemic dysregulatory response to infection, and septic shock occurs when sepsis leads to systemic vasodilation and subsequent tissue hypoperfusion. The Surviving Sepsis Campaign published updated guidelines in 2021 on the management of sepsis and septic shock. Here, in the context of a patient with septic shock, 2 critical care specialists discuss and debate conditional guideline recommendations on using lactate to guide resuscitation, the use of balanced crystalloids versus normal saline, and the use of corticosteroids.

摘要

脓毒症是一种对感染的潜在危及生命的全身失调反应,当脓毒症导致全身血管舒张及随后的组织灌注不足时,就会发生感染性休克。拯救脓毒症运动于2021年发布了关于脓毒症和感染性休克管理的更新指南。在此,在一名感染性休克患者的背景下,两位重症监护专家讨论并辩论了关于使用乳酸盐指导复苏、使用平衡晶体液与生理盐水以及使用皮质类固醇的有条件指南建议。

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