败血症:主要见解、未来方向和近期目标。综述和专家意见

IF 27.1 1区 医学 Q1 CRITICAL CARE MEDICINE Intensive Care Medicine Pub Date : 2024-11-12 DOI:10.1007/s00134-024-07694-z
Ignacio Martin-Loeches, Mervyn Singer, Marc Leone
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引用次数: 0

摘要

这篇综述探讨了败血症的现状和不断发展的认识,强调了挑战和未来的方向。败血症仍然是全球主要的健康负担,其多样化的临床表现使及时诊断和管理变得复杂。包括败血症-3 标准在内的现有定义强调了器官功能障碍的重要性,但早期败血症检测仍受到现有工具的限制。器官功能衰竭顺序评估(SOFA)评分虽然被广泛使用,但可能无法完全捕捉到感染的早期阶段,也无法解释非儿茶酚胺抵抗性休克等复杂表现。此外,综述还强调了脓毒症和休克特征描述迫切需要标准化术语,以确保诊断和治疗策略的一致性。在中低收入国家,由于资源有限,与脓毒症相关的死亡率较高,因此可获得的、与资源相适应的解决方案尤为重要。未来的研究应侧重于开发和验证结合临床、生化和微生物学数据的多参数综合工具,以在全球范围内改善败血症的治疗效果。推进脓毒症治疗需要技术创新和全球一致的合作指南,以消除医疗服务中的差异。
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Sepsis: key insights, future directions, and immediate goals. A review and expert opinion

This review explores the current landscape and evolving understanding of sepsis, highlighting both challenges and future directions. Sepsis remains a major global health burden, with diverse clinical presentations complicating timely diagnosis and management. Existing definitions, including the Sepsis-3 criteria, emphasize the importance of organ dysfunction, yet early sepsis detection remains limited by available tools. The Sequential Organ Failure Assessment (SOFA) score, though widely used, may not fully capture early stages of infection or account for complex presentations like noncatecholamine-resistant shock. Additionally, the review underscores the pressing need for standardized terminology across sepsis and shock characterization to ensure consistency in diagnosis and treatment strategies. Accessible, resource-adapted solutions are particularly crucial in low- and middle-income countries where sepsis-related mortality rates are higher due to limited resources. Future research should focus on developing and validating integrated, multi-parameter tools that combine clinical, biochemical, and microbiological data to improve sepsis outcomes globally. Advancing sepsis care will require both technological innovation and collaborative, globally consistent guidelines to bridge disparities in healthcare delivery.

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来源期刊
Intensive Care Medicine
Intensive Care Medicine 医学-危重病医学
CiteScore
51.50
自引率
2.80%
发文量
326
审稿时长
1 months
期刊介绍: Intensive Care Medicine is the premier publication platform fostering the communication and exchange of cutting-edge research and ideas within the field of intensive care medicine on a comprehensive scale. Catering to professionals involved in intensive medical care, including intensivists, medical specialists, nurses, and other healthcare professionals, ICM stands as the official journal of The European Society of Intensive Care Medicine. ICM is dedicated to advancing the understanding and practice of intensive care medicine among professionals in Europe and beyond. The journal provides a robust platform for disseminating current research findings and innovative ideas in intensive care medicine. Content published in Intensive Care Medicine encompasses a wide range, including review articles, original research papers, letters, reviews, debates, and more.
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