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脓毒性休克管理的最新趋势:对当前证据和建议的叙述性综述

Recent trends in septic shock management: a narrative review of current evidence and recommendations.

作者信息

Nofal Mariam Akram, Shitawi Jawad, Altarawneh Hashem Bassam, Alrosan Sallam, Alqaisi Yanal, Al-Harazneh Al-Mothaffer, Alamaren Ammar Masoud, Abu-Jeyyab Mohammad

机构信息

School of Medicine, Jordan University Hospital, Amman, Jordan.

Internal Medicine, Epsom and St Helier University Hospitals NHS Trust, Sutton, GBR, UK.

出版信息

Ann Med Surg (Lond). 2024 May 15;86(8):4532-4540. doi: 10.1097/MS9.0000000000002048. eCollection 2024 Aug.

DOI:10.1097/MS9.0000000000002048
PMID:39118750
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11305747/
Abstract

Septic shock stands for a group of manifestations that will cause a severe hemodynamic and metabolic dysfunction, which leads to a significant increase in the risk of death by a massive response of the immune system to any sort of infection that ends up with refractory hypotension making it responsible for escalating the numbers of hospitalized patients mortality rate, Organisms that are isolated most of the time are , and . The WHO considers sepsis to be a worldwide health concern; the incidence of sepsis and septic shock have been increasing over the years while being considered to be under-reported at the same time. This review is a quick informative recap of the recent studies regarding diagnostic approaches using lactic acid (Lac), procalcitonin (PCT), Sequential Organ Failure Assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, as well as management recommendations for using vasopressors, fluid resuscitation, corticosteroids and antibiotics that should be considered when dealing with such type of shock.

摘要

感染性休克是一组会导致严重血流动力学和代谢功能障碍的表现,这会因免疫系统对任何类型感染的大规模反应而导致死亡风险显著增加,最终导致难治性低血压,使其成为住院患者死亡率上升的原因。大多数时候分离出的病原体是……和……。世界卫生组织认为脓毒症是一个全球健康问题;脓毒症和感染性休克的发病率多年来一直在上升,同时被认为报告不足。本综述是对近期关于使用乳酸(Lac)、降钙素原(PCT)、序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康状况评估II(APACHE II)评分的诊断方法的快速信息性总结,以及在处理此类休克时应考虑使用血管加压药、液体复苏、皮质类固醇和抗生素的管理建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/001e/11305747/2054805c861a/ms9-86-4532-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/001e/11305747/2054805c861a/ms9-86-4532-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/001e/11305747/2054805c861a/ms9-86-4532-g001.jpg

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本文引用的文献

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Fluid Resuscitation in Septic Patients.脓毒症患者的液体复苏
Cureus. 2023 Aug 29;15(8):e44317. doi: 10.7759/cureus.44317. eCollection 2023 Aug.
2
Management of Sepsis and Septic Shock: What Have We Learned in the Last Two Decades?脓毒症和脓毒性休克的管理:过去二十年我们学到了什么?
Microorganisms. 2023 Sep 4;11(9):2231. doi: 10.3390/microorganisms11092231.
3
Fluids and Early Vasopressors in the Management of Septic Shock: Do We Have the Right Answers Yet?脓毒性休克治疗中的液体与早期血管加压药:我们找到正确答案了吗?
J Crit Care Med (Targu Mures). 2023 Jul 31;9(3):138-147. doi: 10.2478/jccm-2023-0022. eCollection 2023 Jul.
4
SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis.全身炎症反应综合征(SIRS)、序贯器官衰竭评估(SOFA)、快速序贯器官衰竭评估(qSOFA)及国家早期预警评分(NEWS)在脓毒症诊断及不良结局预测中的应用:一项系统评价与荟萃分析
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(8):891-900. doi: 10.1080/14787210.2023.2237192. Epub 2023 Jul 18.
5
New Insights into the Fluid Management in Patients with Septic Shock.脓毒性休克患者液体管理的新见解。
Medicina (Kaunas). 2023 May 29;59(6):1047. doi: 10.3390/medicina59061047.
6
What is new and different in the 2021 Surviving Sepsis Campaign guidelines.2021 年拯救脓毒症运动指南有哪些新的和不同的内容。
Med Klin Intensivmed Notfmed. 2023 Dec;118(Suppl 2):75-79. doi: 10.1007/s00063-023-01028-5. Epub 2023 Jun 7.
7
2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department.2023年成人脓毒症和感染性休克最新进展:急诊科管理
J Clin Med. 2023 Apr 28;12(9):3188. doi: 10.3390/jcm12093188.
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The Timing of Initiating Hydrocortisone and Long-term Mortality in Septic Shock.氢化可的松起始时机与脓毒性休克患者长期死亡率
Anesth Analg. 2023 Oct 1;137(4):850-858. doi: 10.1213/ANE.0000000000006516. Epub 2023 May 12.
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