Table of Contents

HK J Paediatr (New Series)
Vol 8. No. 1, 2003

HK J Paediatr (New Series) 2003;8:3-14

Special Article

Management of Septic Shock: Current Concepts

KCW Chan, AW Chow


Despite the availability of potent antibiotics and a myriad of investigational agents directed against inflammatory mediators, septic shock has remained the most common cause of mortality in the intensive care unit. However, substantial progress has been made in our understanding of the pathophysiology, clinical staging, diagnosis and risk assessment of sepsis and septic shock. Currently, early goal-directed resuscitation and monitoring for haemodynamic support, prompt diagnosis, and effective control of the source of infection has remained the mainstay of management. In this article, the current concepts of the pathophysiology, clinical staging and empirical choice of antibiotics in sepsis and septic shock are briefly reviewed, and the rationale and indications for the use of activated protein C, replacement doses of corticosteroids, and other investigational immunotherapies in severe sepsis and septic shock are discussed.

儘管使用有效抗生素和無數直接針對炎症介質的試驗性藥物,敗血症性休克仍然是加強監護病房中最常見的致死原因,然而,對於敗血症和敗血症性休克的病理生理、臨床分期、診斷和危險因素評估等各方面的了解,已取得實質性進展。目前,臨床上一直應用的主要處理措施包括:早期有針對性地復甦和監測血液動力學、及時診斷和有效控制感染源等。本文簡要地回顧了有關敗血症和敗血症休克的病理生理、臨床分期、選擇抗生素的經驗等方面的當前認識,並對在嚴重敗血症和敗血症性休克病人中應用激活蛋白 C 的基本原則和適應症、皮質類固醇藥物的替代劑量、以及其他試驗性免疫治療方法進行了討論。

Keyword : Sepsis; Shock



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