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AME证据系列001——转化医学协会:脓毒症诊断和早期识别的临床实践指南

Published at: 2016年第36卷第10期

Zhongheng Zhang 1,2 , Nathan J. Smischney 3 , Haibo Zhang 4 , Sven Van Poucke 5 , Panagiotis Tsirigotis 6 , Jordi Rello 7 , Patrick M. Honore 8 , Win Sen Kuan 9 , Juliet June Ray 10 , Jiancang Zhou 11 , You Shang 12 , Yuetian Yu 13 , Christian Jung 14 , Chiara Robba 15 , Fabio Silvio Taccone 16 , Pietro Caironi 17 , David Grimaldi 18 , Stefan Hofer 19 , George Dimopoulos 20 , Marc Leone 21 , Sang-Bum Hong 22 , Mabrouk Bahloul 23 , Laurent Argaud 24 , Won Young Kim 25 , Herbert D. Spapen 26 , Jose Rodolfo Rocco 27
1 Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016
2 Department of Critical Care Medicine, Jinhua Hospital of Zhejiang University, Jinhua Zhejiang 321000
3 Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
4 Keenan Research Center for Biomedical Science of St. Michael’s Hospital, Departments of Anesthesia and Physiology, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
5 Departments of Anesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium
6 2nd Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
7 CIBERES, Vall d’Hebron Institut of Research, Universitat Autonoma de Barcelona, Spain
8 Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel Brussels, Brussels, Belgium
9 Emergency Medicine Department, National University Hospital, National University Health System, Singapore and the Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
10 DeWitt Daughtry Family Department of Surgery, Jackson Memorial Hospital, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
11 Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016
12 Department of Critical Care Medicine, Union Hospital, Tongji Medical Collegue, Huazhong University of Science and Technology, Wuhan 430022
13 Department of Critical Care Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001
14 University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany
15 Neurosciences Critical Care Unit, Addenbrooke’s Hospital, Cambridge, UK
16 Department of Intensive Care, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
17 Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
18 Intensive Care Department, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
19 Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany
20 Department of Critical Care, University Hospital ATTIKON, Medical School, National and Kapodistrian University of Athens, Athens, Greece
21 Service d’anesthésie et de réanimation, Hôpital Nord, Assistance Publique – Hôpitaux de Marseille, Aix Marseille Université, Marseille, France
22 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
23 Department of Intensive Care, Habib Bourguiba University Hospital, Sfax, Tunisia
24 Medical Intensive Care Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
25 Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
26 Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel Brussels, Brussels, Belgium
27 Department of Internal Medicine and Post-graduated Program, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
通讯作者 Zhang Zhongheng Email: zh_zhang1984@hotmail.com
DOI: 10.3978/j.issn.2095-6959.2016.10.001
基金:

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的免疫炎症反应,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(Grades of Recommendation Assessment, Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。


AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital

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引用

引用本文: Zhang Zhongheng , Smischney Nathan J. , Zhang Haibo , Poucke Sven Van , Tsirigotis Panagiotis , Rello Jordi , Honore Patrick M. , Kuan Win Sen , Ray Juliet June , Zhou Jiancang , Shang You , Yu Yuetian , Jung Christian , Robba Chiara , Taccone Fabio Silvio , Caironi Pietro , Grimaldi David , Hofer Stefan , Dimopoulos George , Leone Marc , Hong Sang-Bum , Bahloul Mabrouk , Argaud Laurent , Kim Won Young , Spapen Herbert D. , Rocco Jose Rodolfo . AME证据系列001——转化医学协会:脓毒症诊断和早期识别的临床实践指南[J]. 临床与病理杂志, 2016, 36(10): 1467-1476.
Cite this article as: , , , , , , , , , , , , , , , , , , , , , , , , , . AME evidence series 001—The Society for Translational Medicine: clinical practice guidelines for diagnosis and early identification of sepsis in the hospital[J]. Journal of Clinical and Pathological Research, 2016, 36(10): 1467-1476.