2008年脓毒血症和感染性休克管理国际指南儿科部分.pptVIP

E. Therapeutic End Points(2) Blood pressure (BP) by itself is not a reliable end point for resuscitation. Through thermodilution, therapeutic end points are cardiac index (CI) 3.3 and 6.0 L.min–1.m–2 with normal coronary perfusion pressure (mean arterial pressure – central venous pressure) for age. [290] Using clinical endpoints such as reversal of hypotension and restoration of capillary refill for initial resuscitation at the community hospital level before transfer to a tertiary center was associated with significantly improved survival rates in children with septic shock [305]. Development of a transport system including publicizing to local hospitals and transport with mobile intensive care services significantly decreased the case fatality rate from meningococcal disease in the United Kingdom [316]. 肃槽碾迫脊惶糜腊贡吓胶给橙熬茂瑟覆栏的习陡挡乐龚核钒践灯庐浓胃寨解读2008年脓毒血症与感染性休克管理国际指南儿科部分解读2008年脓毒血症与感染性休克管理国际指南儿科部分 F. Approach to Pediatric Septic Shock Figure 1 shows a flow diagram summarizing an approach to pediatric septic shock [317]. Hospitals should implement two different Severe Sepsis Bundles.? Each bundle articulates requirements for specific timeframes. Sepsis Resuscitation Bundle: Tasks that should begin immediately, but must be done within 6 hours for patients with severe sepsis or septic shock. Sepsis Management Bundle: Tasks that should begin immediately, but must be done within 24 hours for patients with severe sepsis or septic shock. 杀菇疮榜寇辅担叛幅保痔匣薄稀雁亏键贫鉴肢量相苔荷娶宇个钒奎韩劲斑解读2008年脓毒血症与感染性休克管理国际指南儿科部分解读2008年脓毒血症与感染性休克管理国际指南儿科部分 Figure 1 shows a flow diagram summarizing an approach to pediatric septic shock 辜伟陆饭左禽霜讫吐宽兄唐掀蚜损腿棘寥华志熊鸭颊没篮劲纱燕锹咖吗黔解读2008年脓毒血症与感染性休克管理国际指南儿科部分解读2008年脓毒血症与感染性休克管理国际指南儿科部分 G. Steroids 1. We suggest that hydrocortisone therapy be reserved for use in children with catecholamine resistance and suspected or proven adrenal insufficiency (Grade 2C). Patients at risk for adrenal insufficiency include children with severe septic shock and purpura [318, 319],