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[脓毒性休克中液体复苏及血管活性药物的应用:时机、评估标准及规范]

[Fluid resuscitation and application of vasoactive drugs in septic shock: timing, evaluation criteria, and specifications].

作者信息

Lyu H, Song L Q

机构信息

Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2024 Oct 12;47(10):917-920. doi: 10.3760/cma.j.cn112147-20240703-00380.

Abstract

Septic shock (SS), the most severe complication of sepsis, has always been a major challenge and research focus in the field of critical care treatment. SS is categorized as a distributive shock, where fluid resuscitation and the use of vasoactive drugs are the two standard measures for the clinical management of SS. However, it remains unclear how to accurately monitor macro-circulation, micro-circulation, and cellular metabolism indicators during the process of resuscitation, optimization, stabilization, and evacuation based on the dynamic pathophysiological processes of SS. This monitoring is essential to guide the comprehensive, individualized, and dynamic application of these two measures. Based on recent international management guidelines and literature review, the authors will propose relevant recommendations regarding the use of fluid therapy and vasoactive drugs.

摘要

脓毒性休克(SS)是脓毒症最严重的并发症,一直是重症监护治疗领域的重大挑战和研究重点。SS被归类为分布性休克,液体复苏和使用血管活性药物是SS临床管理的两项标准措施。然而,基于SS动态病理生理过程,在复苏、优化、稳定和撤离过程中如何准确监测宏观循环、微循环和细胞代谢指标仍不清楚。这种监测对于指导这两项措施的综合、个体化和动态应用至关重要。基于近期国际管理指南和文献综述,作者将提出关于液体疗法和血管活性药物使用的相关建议。

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