脓毒症专业医学知识宣讲课件.pptVIP

脓毒症专业医学知识宣讲;严重脓毒症及脓毒性休克流行病学;新近流调显示脓毒性休克死亡率下降;脓毒症定义变迁（1.0）;脓毒症定义变迁（2.0）;Diagnostic criteria for sepsis;The PIRO system for staging sepsis;2012;脓毒症诊断标准的“争议”;Do we need a new definition of sepsis? ;; Sepsis 3.0“应运而生”;Sepsis 3.0定义;Sepsis 3.0＝Infection＋SOFA≥2;Septic shock 定义及诊断标准;脓毒症3.0诊断流程;Sepsis 3.0;ACCP反对Sepsis 3.0;ACCP反对Sepsis 3.0;精准医学下的Sepsis 3.0不足;“Dependent and Independent Variables”. Sepsis = ?[(life-threatening)(organ dysfunction)(dysregulated host response)(infection)]. (1) Don’t assume that the sequence of events identified in the new definition reflects pathobiological reality, because no one really knows how things are ordered and connected; (2) Don’t assume that the predominant abnormality in sepsis is immunological–that hypothesis has dominated both mechanistic and therapeutic investigation for over two decades, and has yet to bear fruit. ;精准医学下的Sepsis 3.0不足;Problem #1: Sepsis-III remains subjective;Problem #2: qSOFA SOFA are mortality predictors, not tests for sepsis;Problem #3: Sepsis-III is less specific for infection than Sepsis-II;Problem #4: qSOFA has similar performance compared to SIRS for mortality prediction;Problem #5: qSOFA may be less specific in diseases that directly cause hypotension, tachypnea, or delirium;Sepsis 3.0的10个疑问（六）;Sepsis 3.0的10个疑问（七）;Sepsis 3.0的10个疑问（八）;Sepsis 3.0的10个疑问（九）;Sepsis 3.0的10个疑问（十）;脓毒症未来发展;BMJ：Sepsis的病理生理及临床治疗??;BMJ:当前证据下的脓毒症诊治“取舍”;脓毒症未来发展方向; How does the microbiome change in sepsis and how might this be leveraged therapeutically? ?SEPSIS中微生物如何变化及如何因此调整治疗？ What are the long term physical, cognitive, and psychosocial changes in patients who survive sepsis, and can we develop effective rehabilitative techniques?SEPSIS存活者长期 的躯体、认知、心里有何变化？有效康复技术？ Can we improve the ability of preclinical models of sepsis to predict therapeutic efficacy? 改善SEPSIS临床前模型能力，预测治疗效果 Can we develop a range of point-of-care biomarkers to group patients with sepsis into pathophysiologic categories? This would improve our understanding of