Dabo Trubelja Anahita
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, USA.
SOJ Anesthesiol Pain Manag. 2014;1(1). doi: 10.15226/2374-684x/1/1/00104. Epub 2014 Mar 12.
Septic shock is characterized by an uncontrolled systemic inflammatory response that contributes to organ dysfunction, failure and eventually death. The importance of the adrenal glands for survival under conditions of physiologic stress has been known since the early 20th century. Clinical studies explored the potential therapeutic role of corticosteroids in the treatment of sepsis and septic shock. Despite controversies on the benefit-to-risk ratio, they are widely used. The longstanding adoption of corticosteroids in the treatment of severe sepsis likely relies on the prompt reversal of septic shock often seen at the bedside. This current review was designed to provide readers with a clear understanding and rationale for using corticosteroids, while presenting a review of the Surviving Sepsis Guidelines and the results from the implementation of the Surviving Sepsis Campaign.
脓毒性休克的特征是全身性炎症反应失控，可导致器官功能障碍、衰竭并最终死亡。自20世纪初以来，人们就已经知道肾上腺在生理应激条件下对生存的重要性。临床研究探讨了皮质类固醇在治疗脓毒症和脓毒性休克中的潜在治疗作用。尽管在利弊比方面存在争议，但它们仍被广泛使用。长期以来，皮质类固醇在治疗严重脓毒症中的应用可能依赖于在床边经常见到的脓毒性休克的迅速逆转。本综述旨在让读者清楚地理解使用皮质类固醇的依据，并对《拯救脓毒症指南》以及《拯救脓毒症运动》的实施结果进行综述。
