アブストラクト
| Title | 敗血症性ショックの病態と初期蘇生Up to date |
|---|---|
| Subtitle | 特集 敗血症Up to date 2020 |
| Authors | 鈴木武志*1 |
| Authors (kana) | |
| Organization | *1東海大学医学部医学科外科学系麻酔科 |
| Journal | ICUとCCU |
| Volume | 44 |
| Number | 2 |
| Page | 77-84 |
| Year/Month | 2020 / 2 |
| Article | 報告 |
| Publisher | 医学図書出版 |
| Abstract | 「要約」敗血症の定義が, "感染に伴う全身性の炎症反応" から, "感染に対する制御不能な宿主反応に起因した生命を脅かす臓器障害", へ変更されたものの, その病態は, 感染をトリガーとした全身性炎症反応活性化とそれに引き続く臓器障害および免疫抑制状態であることに変わりはない. その重症系である敗血症性ショックの死亡率は依然高く, その予後改善は急務である. 4年ごとに改訂されているSSCガイドラインにおいて, 循環管理に関する項目だけみてもエビデンスレベルが高いものは少ない. 輸液の指標や輸液負荷のタイミング, 制限的輸液方針の有効性, 心血管作動薬の安全域や第2選択薬を使うタイミングなど, 未解決な課題が多い. 敗血症では心機能障害が早期から進んでおり, 近年β遮断薬の心保護効果が注目され, 心筋保護を視野に入れた治療戦略も選択肢の1つになり得る. 敗血症予後改善に向けては, 今後のさらなる臨床研究の推進が必須である. |
| Practice | 臨床医学：一般 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に1,023円(税込) です。
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