感染性休克液体复苏,小儿各种休克的容量(杨镒宇从化课件(讲课完稿版),2013-12-04)PPT.ppt

Guidelines for Management of Severe Sepsis and Septic Shock，Volume Balance 2012 PS 2008 Fluid Balance 2008 一、成人的肾替代 1.间断血透和持续静脉-静脉血滤(CVVH)被认为是等价的。(2B) 2.CVVH更容易用于管理血流动力学不稳定的患者。(2D) 二、小儿的利尿和肾替代 1.在患儿发生明显液体超负荷前CVVH 或其它肾替代治疗宜用于 无尿或严重少尿（anuria/severe oliguria ）。 Fluid Balance 2012 R. 成人的肾替代疗法 (In SUPPORTIVE THERAPY ,TABLE 8) 对严重脓毒症患者和急性肾衰患者持续肾替代疗法 (CRRTs) 和间断血透是等价的 (grade 2B)。 2. CRRTs可用于管理血流动力学不稳定的脓毒症患者的液体平衡 (grade 2D)。 L. 小儿的利尿和肾替代疗法(In Special Considerations ) 当休克得以解决后应用利尿剂来救治液体超负荷， 如果利尿失败即可应用持续静脉-静脉血滤(CVVH)或间断血透来预防超过10% 的总体重液体超负荷 (grade 2C)。 Surviving Sepsis Campaign （脓毒症拯救运动，SSC） :International guidelines for management of severe sepsis and septic shock  2012 PK 2008 纲要 Approach to Pediatric Shock and Case Report——小儿脓毒症救治流程与病例分析 4 3 Initial Resuscitation and Infection Issues ——启动脓毒症复苏策略与控制感染策略 2 Diagnostic Criteria for Sepsis ——脓毒症诊断标准 1 Surviving Sepsis Campaign ——脓毒症拯救运动（SSC）历史 Surviving Sepsis Campaign— SSC历史 ACCP/SCCMCCC 1992: Bone RC(1991): Definitions of SIRS、Sepsis The 2001 International Sepsis Definitions Conference Sponsor of 2004 guidelines; Sponsor of 2008 guidelines but did not participate formally in revision process; Members of the 2007 SSC Guidelines Committee are listed in Appendix I; Members of the 2012 SSC Guidelines Committee and Pediatric Subgroup are listed in Appendix A at the end of this article. 跨洲、跨国的多中心联合 Sponsoring Organizations（2008） American Association of Critical-Care Nurses*, American College of Chest Physicians*, American College of Emergency Physicians*, Canadian Critical Care Society, European Society of Clinical Microbiology and Infectious Diseases*, European Society of Intensive Care Medicine*, European Respiratory Society*, International Sepsis Forum*, Japanese Association for Acute Medicine, Japanese Society of Intensive Care Medicine, Society of Critical Care Medicine*, Society of Hospital Medicine**, Surgical Infection Society*, World Federation of Societies of Inte