美國胸腔醫學暨重症醫學會ACCP對敗血性休克的定義?

美國胸腔醫學暨重症醫學會ACCP對敗血性休克的定義?

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  • 1 decade ago
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    美國胸腔醫學暨重症醫學會American College of Chest Physicians  ACCP In 1992, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) issued a consensus statement regarding the definitions for sepsis and organ failure.5 This was necessary to encourage accurate tracking of the incidence and prevalence of these disorders, as well as to facilitate the study of innovative treatments. The consensus committee settled on a tiered system of progressively more severe inflammatory states: (1) the systemic inflammatory response syndrome (SIRS); (2) sepsis; (3) severe sepsis; and (4) septic shock.SIRS involves two or more of the following findings: (1) temperature > 38°C or < 36°C; (2) heart rate > 90 beats/min; (3) tachypnea, with a respiratory rate > 20 breaths/min or PaCO2 < 32 mm Hg (4.25 kPa); and (4) WBC count > 12 x 109/L or < 4 x 109/L, or > 10% band forms on a peripheral blood smear. Sepsis is defined as SIRS plus compelling evidence of infection. Severe sepsis is present in a patient who has sepsis with at least one end organ dysfunction. Septic shock is defined as severe sepsis in which one of the organ dysfunctions is hypotension refractory to volume expansion.In 1995, Rangel-Frausto and colleagues reviewed the ability of the consensus conference definitions to describe progressively smaller subsets of more seriously ill inpatients. They found that the mortality rate for patients with SIRS was 7%, rising to 16% for those with sepsis, 20% for severe sepsis, and 46% for septic shock. Fortunately, septic shock accounted for only 4% of admitted patients with an inflammatory state. 美國胸腔醫學暨重症醫學會ACCP對敗血性休克的定義: Septic shock is defined as severe sepsis in which one of the organ dysfunctions is hypotension refractory to volume expansion. 敗血症休克定義為:嚴重敗血症時,低血壓對標準輸液處理治療沒有反應,致使一個以上器官功能異常。

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    1 decade ago

    The American College of Chest Physicians (ACCP)/Society of Critical Care Medicine (SCCM) consensus conference definitions of sepsis, severe sepsis, and septic shock (Bone, 1992) are outlined below. hypotension (ie, systolic blood pressure <90 mm Hg or a reduction of >40 mm Hg from baseline): This may develop despite adequate fluid resuscitation, along with the presence of perfusion abnormalities that may include lactic acidosis, oliguria, or an acute alteration in mental state. Septic shock: A subset of people with severe sepsis develop hypotension despite adequate fluid resuscitation, along with the presence of perfusion abnormalities that may include lactic acidosis, oliguria, or an acute alteration in mental status. Patients receiving inotropic or vasopressor agents may not be hypotensive by the time that they manifest hypoperfusion abnormalities or organ dysfunction. Multiple organ dysfunction syndrome (MODS): This is the presence of altered organ function in a patient who is acutely ill and in whom homeostasis cannot be maintained without intervention.

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