ZhonghengZhang1,2,NathanJ.Smischney3,HaiboZhang4,SvenVanPoucke5,PanagiotisTsirigotis6,JordiRello7,PatrickM.Honore8,WinSenKuan9,JulietJuneRay10,JiancangZhou11,YouShang12,YuetianYu13,ChristianJung14,ChiaraRobba15,FabioSilvioTaccone16,PietroCaironi17,DavidGrimaldi18,StefanHofer19,GeorgeDimopoulos20,MarcLeone21,Sang-BumHong22,MabroukBahloul23,LaurentArgaud24,WonYoungKim25,HerbertD.Spapen26,JoseRodolfoRocco27
1DepartmentofEmergencyMedicine,SirRunRunShawHospital,ZhejiangUniversitySchoolofMedicine,Hangzhou,China;2DepartmentofCriticalCareMedicine,JinhuaHospitalofZhejiangUniversity,Jinhua,China;3DepartmentofAnesthesiology,MayoClinic,Rochester,MN,USA;4KeenanResearchCenterforBiomedicalScienceofSt.Michael’sHospital,DepartmentsofAnesthesiaandPhysiology,InterdepartmentalDivisionofCriticalCareMedicine,UniversityofToronto,Toronto,ON,Canada;5DepartmentsofAnesthesiology,CriticalCare,EmergencyMedicineandPainTherapy,ZiekenhuisOost-Limburg,Genk,Belgium;62ndDepartmentofInternalMedicine,AttikonUniversityHospital,MedicalSchool,NationalandKapodistrianUniversityofAthens,Athens,Greece;7CIBERES,Valld’HebronInstitutofResearch,UniversitatAutonomadeBarcelona,Spain;8UniversitairZiekenhuisBrussel,VrijeUniversiteitBrusselBrussels,Brussels,Belgium;9EmergencyMedicineDepartment,NationalUniversityHospital,NationalUniversityHealthSystem,SingaporeandtheDepartmentofSurgery,YongLooLinSchoolofMedicine,NationalUniversityofSingapore,Singapore;10DeWittDaughtryFamilyDepartmentofSurgery,JacksonMemorialHospital,UniversityofMiamiLeonardM.MillerSchoolofMedicine,Miami,FL,USA;11DepartmentofCriticalCareMedicine,SirRunRunShawHospital,ZhejiangUniversitySchoolofMedicine,Hangzhou,China;12DepartmentofCriticalCareMedicine,UnionHospital,TongjiMedicalCollegue,HuazhongUniversityofScienceandTechnology,Wuhan,China;13DepartmentofCriticalCareMedicine,RenjiHospital,ShanghaiJiaoTongUniversitySchoolofMedicine,Shanghai,China;14UniversityHospitalDüsseldorf,Heinrich-Heine-UniversityDüsseldorf,MedicalFaculty,DivisionofCardiology,PulmonologyandVascularMedicine,Düsseldorf,Germany;15NeurosciencesCriticalCareUnit,Addenbrooke’sHospital,Cambridge,UK;16DepartmentofIntensiveCare,H?pitalErasme,UniversitéLibredeBruxelles(ULB),Brussels,Belgium;17DipartimentodiFisiopatologiaMedico-ChirurgicaedeiTrapianti,FondazioneIRCCSCa’Granda–OspedaleMaggiorePoliclinico,UniversityofMilan,Milan,Italy;18IntensiveCareDepartment,H?pitalErasme,UniversitéLibredeBruxelles,Brussels,Belgium;19DepartmentofAnesthesiology,UniversityofHeidelberg,Heidelberg,Germany;20DepartmentofCriticalCare,UniversityHospitalATTIKON,MedicalSchool,NationalandKapodistrianUniversityofAthens,Athens,Greece;21Serviced’anesthésieetderéanimation,H?pitalNord,AssistancePublique–H?pitauxdeMarseille,AixMarseilleUniversité,Marseille,France;22DepartmentofPulmonaryandCriticalCareMedicine,AsanMedicalCenter,UniversityofUlsanCollegeofMedicine,Seoul,Korea;23DepartmentofIntensiveCare,HabibBourguibaUniversityHospital,Sfax,Tunisia;24MedicalIntensiveCareUnit,EdouardHerriotHospital,HospicesCivilsdeLyon,Lyon,France;25DepartmentofEmergencyMedicine,AsanMedicalCenter,UniversityofUlsanCollegeofMedicine,Seoul,Korea;26UniversitairZiekenhuisBrussel,VrijeUniversiteitBrusselBrussels,Brussels,Belgium;27DepartmentofInternalMedicineandPost-graduatedProgram,HospitalUniversitárioClementinoFragaFilho,FederalUniversityofRiodeJaneiro,RiodeJaneiro,Brazil
张建成1尚游1译
钟鸣2审校
(1.华中科技医院，武汉；2.医院重症医学科，上海)
摘要
脓毒症是一种由感染引起的异质性疾病，感染触发了一系列复杂的局部或者全身免疫炎症反应，引起多器官功能衰竭，发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准，所以脓毒症的临床诊断仍是一个难题。因此，脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而，尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险，但是这些措施的诊断价值和有效性不足以让人满意，并且没有充分的证据去建议临床使用这些新技术。因此，脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(GradesofRe白癜风早期有什么症状白癜风医院在哪里
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