小儿败血症:当前定义和管理建议综述。

IF 3.6 Q1 PEDIATRICS Current pediatrics reports Pub Date : 2023-01-01 Epub Date: 2023-05-09 DOI:10.1007/s40124-023-00286-3
Mariana Miranda, Simon Nadel
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引用次数: 1

摘要

综述目的:小儿败血症仍是儿童发病率和死亡率的重要原因。这篇综述将总结该定义的主要方面,目前干预措施的证据基础讨论了一些有争议的主题,并指出了可能的改进领域。最近的发现:关于准确的定义、复苏液的体积和类型、血管活性/肌力药物的选择以及根据特定感染风险选择的抗生素,仍存在争议。许多辅助疗法已被提出具有理论益处,尽管明确的建议尚未得到数据支持。我们描述了基于国际指南的最佳实践建议,对主要文献的回顾,以及对正在进行的临床试验和治疗选择的细微差别的讨论。摘要:早期诊断和及时使用抗生素、液体复苏和血管活性药物进行干预是败血症最重要的干预措施。方案、资源调整的败血症捆绑包和先进技术的实施将对降低败血症死亡率产生影响。
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Pediatric Sepsis: a Summary of Current Definitions and Management Recommendations.

Purpose of review: Pediatric sepsis remains an important cause of morbidity and mortality in children. This review will summarize the main aspects of the definition, the current evidence base for interventions discuss some controversial themes and point towards possible areas of improvement.

Recent findings: Controversy remains regarding the accurate definition, resuscitation fluid volume and type, choice of vasoactive/inotropic agents, and antibiotic depending upon specific infection risks. Many adjunctive therapies have been suggested with theoretical benefits, although definitive recommendations are not yet supported by data. We describe best practice recommendations based on international guidelines, a review of primary literature, and a discussion of ongoing clinical trials and the nuances of therapeutic choices.

Summary: Early diagnosis and timely intervention with antibiotics, fluid resuscitation, and vasoactive medications are the most important interventions in sepsis. The implementation of protocols, resource-adjusted sepsis bundles, and advanced technologies will have an impact on reducing sepsis mortality.

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