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脓毒性休克早期液体复苏的临床反应性评价 被引量：4

Clinical Evaluation of the Response of Patients with Septic Shock to Early Fluid Resuscitation
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摘要 目的探讨脓毒性休克早期液体复苏的临床反应性。方法对2008年2月～2010年2月38例采用早期目标定向治疗方案治疗的脓毒性休克患者按是否存活进行分组,就中心静脉压、心率、平均动脉压、输液量、尿量、血乳酸等指标进行评价。结果 38例采用早期目标定向治疗方案治疗6h均达标,存活21例(55.26%),死亡17例(44.74%),两组患者输液总量及输液种类差异无统计学意义(P>0.05),存活组6、24h尿量及血乳酸清除率明显优于死亡组(P<0.05)。结论血乳酸清除率及尿量可作为脓毒性休克液体复苏有效的临床监测指标。 Objective To study the clinical response to early fluid resuscitation therapy in septic shock patients.Methods Thirty-eight septic shock patients received early goal-directed therapy（EGDT） in the ICU of our hospital from February 2008 to February 2010.The patients were divided into survival group（n=21） and dead group（n=17）.Indexes like central venous pressure（CVP）,heart rate（HR）,mean arterial pressure（MAP）,fluid input,urine output,and blood lactate were evaluated.Results Six hours after the EGDT,the results for the patients were all up to standard.There were 21 cases of survival（55.26%） and 17 cases of death（44.74%）.The total fluid input and liquid types were similar in the two groups（P0.05）.The urine output and lactate clearance at hour 6 and 24 for the survival group were better than that for the dead group（P0.05）.Conclusion The lactate clearance and urine output can be regarded as an surveillance indicator of fluid resuscitation for patients with septic shock.
作者 杨明全 曹建伟 陈燕梅
机构地区 自贡市第一人民医院重症医学科
出处 《华西医学》 CAS 2011年第6期863-866,共4页 West China Medical Journal
关键词 脓毒性休克 液体复苏 血乳酸清除率 尿量 Septic shock Fluid resuscitation Blood lactate clearance Urine output
分类号 R459.7 [医药卫生—急诊医学]
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参考文献12

  • 1强新华,康焰.脓毒血症和感染性休克的治疗现状[J].华西医学,2005,20(4):791-792. 被引量：6
  • 2American Colege of Chest Physiciana/Society of Critical Care Medicine Consensus Confeernce. Definitionsforse psisa ndorgan failure and guidelines for the use of innovative therapies in sepsis [J]. Crit Care Med, 1992, 20(6) : 864-874.
  • 3Dellinger RP, Levy MM, Carlet JM, et al. Surviving Sepsis Campaign= International guidelines for management of severe sepsis and septic shock= 2008[J]. Crit Care Med, 2008, 36(1): 296-327.
  • 4Rivers E, Nguyen B, Havstad S, et al. Early goal directed therapy in the treatment of severe sepsis and septic shock[J]. N Engl J Med, 2001, 345(19): 1368-1377.
  • 5Lee SW, Hong YS, Park DW, et al. Lactic acidosis not hyperlactatemia as a predictor of inhospital mortality in septic emergency patients[J]. Emergency Medicine J, 2008, 25 (10) : 659-665.
  • 6Nguyen HB, Rivers EP, Knoblicb BP, et al. Earlylaclate clearanceis associated with improved outcome in severe sepsis and septic shock[J]. Dtit Care Med, 2004, 32(8): 1785-1786.
  • 7Sablotzki A, Muhling J, Czeslick E. Sepsis and muhiple organ failure-update of current therapeutic concepts[J]. Anasthesiol Intensivmed Notfallmed Sehmerzthe, 2005, 40(9) : 511-520.
  • 8Dellinger RP. Cardiovascular management of septic shock[J]. Crit Care Med, 2003, 31(3): 946-955.
  • 9Finfer S, 13ellomo R, Boyce N, el al. A comparison of albumin and saline for fluid resuscitation in the intensive care unil[J]. N EnglJ Med, 2004, 350(22): 2247-2256.
  • 10Alsous F, Khamices M, DeGirolamo A, el al. Negative fluid balance predicts surgival in patients with septic shock: a retrospective pilot study[J]. Chest, 2000, 117(6): 1749-1754.

二级参考文献31

  • 1Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.The ACCP/SCCM Consensus Conference Committee.American College of Chest Physicians/ Society of Critical Care Medicine[J].Chest,1992; 101:1644-1655.
  • 2Matot I,Sprung CL.Definition of sepsis[J].Intensive Care Med,2001,27:S3-S9.
  • 3Opal SM,Esmon CT.Bench-to-bedside review: functional relationships between coagulation and the innate immune response and their respective roles in the pathogenesis of sepsis[J].Crit Care,2003,7:23-38.
  • 4Landry DW,Oliver JA.The pathogenesis of vasodilatory shock[J].N Engl J Med,2001,345:588-595.
  • 5Rivers E,Nguyen B,Havstad S,et al.Early goal-directed therapy in the treatment of severe sepsis and septic shock[J].N Engl J Med,2001,345:1368-1377.
  • 6Dellinger RP,Carlet JM,Masur H,et al.Surviving sepsis campaign guidelines for management of severe sepsis and septic shock[J].Crit Care Med,2004,32:858-873.
  • 7MacArthur RD,Miller M,Albertson T,et al.Adequacy of early empiric antibiotic treatment and survival in severe sepsis: experience from the MONARCS trial[J].Clin Infect Dis,2004,38:284-288.
  • 8Leibovici L,Paul M,Poznanski O,et al.Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia: a prospective,observational study[J].Antimicrob Agents Chemother,1997,41:1127.
  • 9Balk RA.Severe sepsis and septic shock: definitions,epidemiology,and clinical manifestations[J].Crit Care Clin,2000,16:179-192.
  • 10The Acute Respiratory Distress Syndrome Network.Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome[J].N Engl J Med,2000,342:1301-1308.

共引文献12

同被引文献61

  • 1王东浩.乳酸清除率评估重度脓毒症患者预后的临床分析[J].中国急救医学,2007,27(1):15-17. 被引量：97
  • 2Levy MM, Dellinger RP, Townsend SR, et al. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis[J]. Intensive Care Med, 2010, 36(2): 222-231.
  • 3American College of Chest Physiciana/Society of Critical Care Medicine Consensus Confeernce. Definitionsforse psisa ndorgan failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20(6): 864-874.
  • 4Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008[J]. Crit Care Med, 2008, 36(1): 296-327.
  • 5Lee SW, Hong YS, Park DW, et al. Lactic acidosis not hyperlactatemia as a predictor of inhospital mortality in septic emergency patients[J]. Emerg Med J, 2008, 25(10): 659-665.
  • 6Gunnerson KJ, Saul M, He S, et al. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients[J]. Crit Care, 2006, 10(1): R22.
  • 7Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: arandomized clinical trial[J]. JAMA, 2010, 303(8): 739-746.
  • 8Palma LC, Ferreira GF, Amaral ACKB, et al. Acidosis and mortality in severe sepsis and septic shock evaluated by base excess variation [J]. Critical Care, 2003, 7(Suppl 3): 39.
  • 9Allen M. Lactate and acid base as a hemodynamic monitor and markers of cellular perfusion[J]. Pediatr Crit Care Med, 2011, 12(4 Suppl): S43- S49.
  • 10Surbatovic M, Radakovic S, Jevtic M, et al. Predictive value of serum bicarbonate, arterial base deficit/excess and SAPS Ⅲ score in critically ill patients[J]. Gen Physiol Biophys, 2009, 28: 271-276.

引证文献4

二级引证文献36

华西医学
2011年 第6期

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