Surviving sepsis a guide to the guidelines 英文参考文献.docVIP

Available online /content/12/3/162 Commentary Surviving sepsis: a guide to the guidelines Jean-Louis Vincent1 and John C Marshall2 1Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium 2Department of Surgery and Critical Care Medicine, St Michael’s Hospital, Bond Wing 4-007, 30 Bond Street, Ontario, M5B 1W8 Canada Corresponding author: Dr Jean-Louis Vincent, jlvincen@ulb.ac.be Published: 30 June 2008 Critical Care 2008, 12:162 (doi:10.1186/cc6924) This article is online at /content/12/3/162 ? 2008 BioMed Central Ltd Abstract what questions are considered important. Included studies were limited to those published in peer-reviewed journals, to minimize the risk of overinterpreting studies that had not undergone independent peer review. The revised Surviving Sepsis Campaign (SSC) guidelines for the management of severe sepsis and septic shock have recently been published. These guidelines represent the end product of an intense process and provide a template approach to the early resuscitation and support of patients with sepsis, based on a synthesis of evidence that has been shown to improve the outcome of the septic patient. The SSC guidelines arose from a recognition that care of the septic patient was suboptimal for at least three reasons. First, the entity of sepsis was frequently not diagnosed in a timely fashion, allowing the process to evolve into a life-threatening syndrome of major physiologic organ system dysfunction. Secondly, even when sepsis was recognized, the urgency of treatment was underappreciated – and so haemodynamic resuscitation was tentative, and the administration of effective antibiotic therapy was often delayed. Finally, treatment was often suboptimal, and failed to take advantage of emerging insights into optimal approaches to patient management. The revised guidelines a