Sepsis和Septic Shock 新定义说明.pptVIP

Sepsis和Septic Shock 新定义 Sepsis 定义的发展过程 Sepsis-1 1991年 Sepsis-2 2001年 Sepsis-3 2016年 Sepsis-1 A 1991 consensus conference developed initial definitions that focused on the then-prevailing view that sepsis resulted from a host’s systemic inflammatory response syndrome (SIRS) to infection Sepsis=感染+ SIRS≥2 Sepsis-1 SIRS标准的特异性过低 一患扁桃体炎的男孩绕着操场跑一圈，心率100+，呼吸25次，完全符合Sepsis的SIRS诊断标准 Sepsis-2 A 2001 task force, recognizing limitations with these definitions, expanded the list of diagnostic criteria but did not offer alternatives because of the lack of supporting evidence.In effect, the definitions of sepsis, septic shock, and organ dysfunction have remained largely unchanged for more than 2 decades. The Third International Consensus Definitionsfor Sepsis and Septic Shock (Sepsis-3) ——JAMA February 23,2016;315(8):801-810. Importance Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function,morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. Objective To evaluate and, as needed, update definitions for sepsis and septic shock. Process A task force with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement. Definition Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalitie