Common Sense Approach to Managing Sepsis

被引:4
作者
Perner, Anders [1 ]
Holst, Lars B. [1 ]
Haase, Nicolai [1 ]
Hjortrup, Peter B. [1 ]
Moller, Morten H. [1 ]
机构
[1] Univ Copenhagen, Rigshosp, Dept Intens Care, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
关键词
Sepsis; Resuscitation; Hemodynamic monitoring; Antibiotics; Critical care; Fluids; INTERNATIONAL CONSENSUS DEFINITIONS; PREDICTING FLUID RESPONSIVENESS; SEPTIC SHOCK; CARE; THERAPY; MANAGEMENT; OUTCOMES; TRIAL; RESUSCITATION; LEVOSIMENDAN;
D O I
10.1016/j.ccc.2017.08.009
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Sepsis results in many deaths, prolonged suffering among survivors and relatives, and a high use of resources both in developed and developing countries. The updated Surviving Sepsis Campaign guidelines should aid clinicians in improving the identification and management of these patients, but many uncertainties remain because most of the guidance is based on low-quality evidence. This article discusses how to use some of the specific items of the guidelines together with a common-sense approach to aid clinical management of patients with sepsis while trying to balance the potential benefit and harm of the items.
引用
收藏
页码:127 / +
页数:13
相关论文
共 61 条
[1]   A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators [J].
Angus, D. C. ;
Barnato, A. E. ;
Bell, D. ;
Bellomo, R. ;
Chong, C. -R. ;
Coats, T. J. ;
Davies, A. ;
Delaney, A. ;
Harrison, D. A. ;
Holdgate, A. ;
Howe, B. ;
Huang, D. T. ;
Iwashyna, T. ;
Kellum, J. A. ;
Peake, S. L. ;
Pike, F. ;
Reade, M. C. ;
Rowan, K. M. ;
Singer, M. ;
Webb, S. A. R. ;
Weissfeld, L. A. ;
Yealy, D. M. ;
Young, J. D. .
INTENSIVE CARE MEDICINE, 2015, 41 (09) :1549-1560
[2]   High versus Low Blood-Pressure Target in Patients with Septic Shock [J].
Asfar, Pierre ;
Meziani, Ferhat ;
Hamel, Jean-Francois ;
Grelon, Fabien ;
Megarbane, Bruno ;
Anguel, Nadia ;
Mira, Jean-Paul ;
Dequin, Pierre-Francois ;
Gergaud, Soizic ;
Weiss, Nicolas ;
Legay, Francois ;
Le Tulzo, Yves ;
Conrad, Marie ;
Robert, Rene ;
Gonzalez, Frederic ;
Guitton, Christophe ;
Tamion, Fabienne ;
Tonnelier, Jean-Marie ;
Guezennec, Pierre ;
Van der Linden, Thierry ;
Vieillard-Baron, Antoine ;
Mariotte, Eric ;
Pradel, Gael ;
Lesieur, Olivier ;
Ricard, Jean-Damien ;
Herve, Fabien ;
du Cheyron, Damien ;
Guerin, Claude ;
Mercat, Alain ;
Teboul, Jean-Louis ;
Radermacher, Peter .
NEW ENGLAND JOURNAL OF MEDICINE, 2014, 370 (17) :1583-1593
[3]   GRADE guidelines: 3. Rating the quality of evidence [J].
Balshem, Howard ;
Helfand, Mark ;
Schuenemann, Holger J. ;
Oxman, Andrew D. ;
Kunz, Regina ;
Brozek, Jan ;
Vist, Gunn E. ;
Falck-Ytter, Yngve ;
Meerpohl, Joerg ;
Norris, Susan ;
Guyatt, Gordon H. .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2011, 64 (04) :401-406
[4]   Dangers and opportunities of guidelines in the data-free zone [J].
Bonten, Marc J. M. .
LANCET RESPIRATORY MEDICINE, 2015, 3 (09) :670-672
[5]   Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial [J].
Bouadma, Lila ;
Luyt, Charles-Edouard ;
Tubach, Florence ;
Cracco, Christophe ;
Alvarez, Antonio ;
Schwebel, Carole ;
Schortgen, Frederique ;
Lasocki, Sigismond ;
Veber, Benoit ;
Dehoux, Monique ;
Bernard, Maguy ;
Pasquet, Blandine ;
Regnier, Bernard ;
Brun-Buisson, Christian ;
Chastre, Jean ;
Wolff, Michel .
LANCET, 2010, 375 (9713) :463-474
[6]   Perioperative buffered versus non-buffered fluid administration for surgery in adults [J].
Burdett, Edward ;
Dushianthan, Ahilanandan ;
Bennett-Guerrero, Elliott ;
Cro, Suzie ;
Gan, Tong J. ;
Grocott, Michael P. W. ;
James, Michael F. M. ;
Mythen, Michael G. ;
O'Malley, Catherine M. N. ;
Roche, Anthony M. ;
Rowan, Kathy .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2012, (12)
[7]   Safety of peripheral intravenous administration of vasoactive medication [J].
Cardenas-Garcia, Jose ;
Schaub, Karen F. ;
Belchikov, Yuly G. ;
Narasimhan, Mangala ;
Koenig, Seth J. ;
Mayo, Paul H. .
JOURNAL OF HOSPITAL MEDICINE, 2015, 10 (09) :581-585
[8]   Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion [J].
Carson, Jeffrey L. ;
Carless, Paul A. ;
Hebert, Paul C. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2012, (04)
[9]   Comparison of Dopamine and Norepinephrine in the Treatment of Shock. [J].
De Backer, Daniel ;
Biston, Patrick ;
Devriendt, Jacques ;
Madl, Christian ;
Chochrad, Didier ;
Aldecoa, Cesar ;
Brasseur, Alexandre ;
Defrance, Pierre ;
Gottignies, Philippe ;
Vincent, Jean-Louis .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (09) :779-789
[10]   Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial [J].
de Jong, Evelien ;
van Oers, Jos A. ;
Beishuizen, Albertus ;
Vos, Piet ;
Vermeijden, Wytze J. ;
Haas, Lenneke E. ;
Loef, Bert G. ;
Dormans, Tom ;
van Melsen, Gertrude C. ;
Kluiters, Yvette C. ;
Kemperman, Hans ;
van den Elsen, Maarten J. ;
Schouten, Jeroen A. ;
Streefkerk, Joern O. ;
Krabbe, Hans G. ;
Kieft, Hans ;
Kluge, Georg H. ;
van Dam, Veerle C. ;
van Pelt, Joost ;
Bormans, Laura ;
Otten, Martine Bokelman ;
Reidinga, Auke C. ;
Endeman, Henrik ;
Twisk, Jos W. ;
van de Garde, Ewoudt M. W. ;
de Smet, Anne Marie G. A. ;
Kesecioglu, Jozef ;
Girbes, Armand R. ;
Nijsten, Maarten W. ;
de lange, Dylan W. .
LANCET INFECTIOUS DISEASES, 2016, 16 (07) :819-827