感染性休休克和微循环.pptVIP

感染性休克的主战场-微循环 ●●● ●●●●● ●●●● ●●●●● ●●●● ●●●●  ●●● ●●@ ●●0● ●● ●感染的治疗原则: 0●0 “脓液引流”+抗菌素十“液体” ↑ 外科控制感染的源头,如坏死组织的清除、脓液的引流  ●●● ●●@ ●@0●0 ● ●感染的治疗原则: 0●0 脓液引流”+抗菌素+“液体” 个 如达托霉素治疗MRSA血流感染和自身瓣膜感染性心内膜炎  ●●● ●●@ ●@0●0 ● ●感染的治疗原则: 0●0 脓液引流”+抗菌素+“液体” 仅仅只是液体的复苏,没有修复毛细血管的渗漏  Acuto inflammatory insu FIRSTH muma isetan Bums, Sepala, Fleeing ●●● ●●@ Sylmic pront mmatay cytosine release ●●0● ●● ●●0 Microcirculatory dysfunction Organ Dysfunction: MoDS 8ECcHD HIT 472 Shock d sheek cytokines =dena clearing of ventilator Kidney Edsra Surve Cordemans et al. Annals of Intensive Care 2012, 2 (suppl 1): S1  Acuto inflammatory insu FIRSTH muma isetan Bums, Sepala, Fleeing ●●@@ Acute inflammatory insult SIRS Microcirculation dysfunction distributive shock ●●0 Microcirculatory dysfunction Organ Dysfunction: MoDS 8ECcHD HIT 472 Shock d sheek cytokines Surve Cordemans et al. Annals of Intensive Care 2012, 2 (suppl 1): S1  Acuto inflammatory insu FIRSTH muma isetan Bums, Sepala, Fleeing ●●● ●●@ Sylmic pront mmatay cytosine release ●●0● ●● ●●0 Microcirculatory dysfunction Organ dy undor: MoDS-SCOyD YLWIT f acrenwvp organ dysfunction: MODS 472 Shock d sheek cytokines =dena clearing of ventilator Unresolved shock Surve Cordemans et al. Annals of Intensive Care 2012, 2 (suppl 1): S1  Acuto inflammatory insu FIRSTH muma isetan Bums, Sepala, Fleeing ●●● ●●@ Sylmic pront mmatay cytosine release ●●0● ●● ●●0 Microcirculatory dysfunction Organ dy undor: MoDS-SCOyD YLWIT f acrenwvp organ dysfunction: MODS 472 Shock d sheek cytokines =dena clearing of ventilator Unresolved shock Surve Cordemans et al. Annals of Intensive Care 2012, 2 (suppl 1): S1  ●●● ●●@ ● 0●0 流感病毒感染导致肺的炎性风暴 炎性风暴( Cytokine storm): 低血压 HR↑ 呼吸困难 发热 难以控制的出血 重要器官的缺血,多器官衰竭  Pulmonary capillary leak syndrome after influenza A 400. ●@0●0 ● (H1N1)virus infection 0●0 肺泡性肺水肿 Journal of Infection(2011)63, 317-319