脓毒症诊断指南

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1、Received:21February2003Accepted:21February2003Publishedonline:28March2003?Springer-Verlag2003PublishedjointlywithCriticalCareMedicineConferenceParticipants:MitchellM・Levy(Co-Chair),GrahamRamsay(Co-Chair),EdwardAbraham,DerekAngus,RobertBalk,GordonBernard,JulianBion,JosephCarcillo,Jean

2、M.Carlet,JonathanCohen,DeborahCook,Jean-Fran?oisDhainaut,TimEvans,MitchellP.Fink,DonaldE.Fry,HerwigGerlach,SteveLowry,MarkA.Malangoni,JohnC.Marshall,GeorgeMatuschak,StevenM.Opal,JosephE.Parillo,KonradReinhart,WilliamJ.Sibbald,CharlesL.Sprung,Jean-LouisVincent,MaxH.WeilS.M.OpalBrownUn

3、iversitySchoolofMedicine,MemorialHospitalofRhodeIsland,ProvidenceRI,USAJ.-L.VincentUniversityHospitalErasme,Brussels,BelgiumG.RamsayUniversityHospital,Maastricht,TheNetherlandscietyofIntensiveCareMedicine(ESICM),TheAmericanCollegeofChestPhysicians(ACCP),theAmericanThoracicSociety(AT

4、S),andtheSurgicalInfectionSociety(SIS).Methods:29participantsattendedtheconferencefromEuropeandNorthAmerica.Inadvanceoftheconference,subgroupswereformedtoevalu・atethefollowingareas:signsandsymptomsofsepsis,cellmarkers,cytokines,microbiologicdata,andcoagulationparameters-•Thepresent

5、manuscriptservesasthefinalreportofthe2001InternationalSepsisDefini・tionsConference.Conclusion:LCurrentconceptsofsepsis,severesepsisandsepticshockremainusefultocliniciansandresearchers.2.Thesedefi・PANELnitionsdonotallowprecisestagingorprognosticationofthehostresponsetoinfection.3.Wh

6、ileSIRSremainsausefulconcept,thediagnosticcriteriaforSIRSpublishedin1992areoverlysensitiveandnon-specific.4.Anex・pandedlistofsignsandsymptomsofsepsismaybetterreflecttheclinicalresponsetoinfection.6.PIRO,ahypotheticalmodelforstagingsepsisispresented,which,inthefuture,maybettercharact

7、erizethesyndromeonthebasisofpredisposingfactorsandpremorbidconditions,thenatureoftheunderlyinginfection,thecharacteristicsofthehostresponse,andtheextentoftheresultantorgandysfunction.KeywordsSepsis•SevereSepsis•SepticShock•SIRS•PIROIntensiveCareMed(2003)29:530-538DOI10.1007/s00134-

8、003-1662-xEX