Progress on the early diagnosis and treatment of sepsis

doi:10.3877/cma.j.issn.1673-9450.2022.01.014

Abstract

Abstract:

Sepsis is a global public health problem characterized by high morbidity, severe illness and high mortality, becoming one of the main causes of death in intensive care unitl patients. Early diagnosis of sepsis is the key to reduce fatality rate, but there is no golden standerd for diagnosis. In recent years, the combination therapies of fluid resuscitation and antibiotics have been the main treatment methods for sepsis, but there are still many controversies in many aspects. In addition, immunotherapy is one of the hot spots in the treatment of sepsis. This article tries to summarize and expound the progress in the early diagnosis and treatment of sepsis.

Key words: Sepsis, Early diagnosis, Clinical treatment, Immunotherapy

Jinxin Zhang, Kuo Shen, Dahai Hu, Wen Yin. Progress on the early diagnosis and treatment of sepsis[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(01): 76-80.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhssyxfzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9450.2022.01.014

https://zhssyxfzz.cma-cmc.com.cn/EN/Y2022/V17/I01/76

References 51

[1]	中国医师协会急诊医师分会，中国研究型医院学会休克与脓毒症专业委员会. 中国脓毒症/脓毒性休克急诊治疗指南(2018)[J]. 感染、炎症、修复，2019, 20(1): 3-22.
[2]	Xie J, Wang H, Kang Y, et al. The Epidemiology of Sepsis in Chinese ICUs: A National Cross-Sectional Survey[J]. Crit Care Med, 2020, 48(3): e209-e218.
[3]	Paoli CJ, Reynolds MA, Sinha M, et al. Epidemiology and Costs of Sepsis in the United States-An Analysis Based on Timing of Diagnosis and Severity Level[J]. Crit Care Med, 2018, 46(12): 1889-1897.
[4]	Gaieski DF, Edwards JM, Kallan MJ, et al. Benchmarking the incidence and mortality of severe sepsis in the United States[J]. Crit Care Med, 2013, 41(5): 1167-1174.
[5]	中国医疗保健国际交流促进会急诊医学分会，中华医学会急诊医学分会，中国医师协会急诊医师分会，等. 中国脓毒症早期预防与阻断急诊专家共识[J]. 临床急诊杂志，2020, 21(7): 517-529.
[6]	Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA, 2016, 315(8): 801-810.
[7]	Freund Y, Lemachatti N, Krastinova E, et al. Prognostic Accuracy of Sepsis-3 Criteria for In-Hospital Mortality Among Patients With Suspected Infection Presenting to the Emergency Department[J]. JAMA, 2017, 317(3): 301-308.
[8]	Mcgrath SP, Perreard I, Mackenzie T, et al. Improvement of sepsis identification through multi-year comparison of sepsis and early warning scores[J]. Am J Emerg Med, 2022, 51: 239-247.
[9]	Usman OA, Usman AA, Ward MA. Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the Emergency Department[J]. Am J Emerg Med, 2019, 37(8): 1490-1497.
[10]	陈师林，王兰，邓亚萍. 脓毒症早期识别及评估预后的生物标志物的研究进展[J]. 中国医药导报，2019, 16(10): 52-55.
[11]	郭磊，沈华，张铮. 脓毒症的新型生物标志物研究进展[J]. 内科急危重症杂志，2020, 26(2): 155-158.
[12]	刘昌，张靖垚. 腹腔感染诊治新理念：共识与争议[J]. 中国实用外科杂志，2019, 39(0): 538-541.
[13]	Rivers 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.
[14]	ProCESS Investigators, Yealy DM, Kellum JA, et al. A randomized trial of protocol-based care for early septic shock[J]. N Engl J Med, 2014, 370(18): 1683-1693.
[15]	ARISE Investigators, ANZICS Clinical Trials Group, Peake SL, et al. Goal-directed resuscitation for patients with early septic shock[J]. N Engl J Med, 2014, 371(16): 1496-1506.
[16]	Lilly CM. The ProCESS trial--a new era of sepsis management[J]. N Engl J Med, 2014, 370(18): 1750-1751.
[17]	任建安. 脓毒症液体治疗争论与进展[J]. 中国实用外科杂志，2020, 40(1): 33-36.
[18]	Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 Update[J]. Crit Care Med, 2018, 46(6): 997-1000.
[19]	Brown RM, Wang L, Coston TD, et al. Balanced Crystalloids versus Saline in Sepsis. A Secondary Analysis of the SMART Clinical Trial[J]. Am J Respir Crit Care Med, 2019, 200(12): 1487-1495.
[20]	毛小强，楼炳恒，吴德军. 乳酸林格氏液与生理盐水对脓毒性休克患者临床疗效的比较[J]. 中国医学科学院学报，2018, 40(3): 349-355.
[21]	Casey JD, Brown RM, Semler MW. Resuscitation fluids[J]. Curr Opin Crit Care, 2018, 24(6): 512-518.
[22]	Orbegozo Cortés D, Gamarano Barros T, Njimi H, et al. Crystalloids versus colloids: exploring differences in fluid requirements by systematic review and meta-regression[J]. Anesth Analg, 2015, 120(2): 389-402.
[23]	Rhodes A, Evans LE, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016[J]. Intensive Care Med, 2017, 43(3): 304-377.
[24]	Antal O, Ştefãnescu E, Mleşnie M, et al. Initial Fluid Resuscitation Following Adjusted Body Weight Dosing in Sepsis and Septic Shock[J]. J Crit Care Med (Targu Mures), 2019, 5(4): 130-135.
[25]	Butz J, Shan Y, Samayoa A, et al. The utility of impedance cardiography in hemodynamic monitoring of patients with sepsis[J]. Trauma Surg Acute Care Open, 2019, 4(1): e000349.
[26]	Liu VX, Fielding-Singh V, Greene JD, et al. The Timing of Early Antibiotics and Hospital Mortality in Sepsis[J]. Am J Respir Crit Care Med, 2017, 196(7): 856-863.
[27]	Klompas M, Calandra T, Singer M. Antibiotics for Sepsis-Finding the Equilibrium[J]. JAMA, 2018, 320(14): 1433-1434.
[28]	Minderhoud TC, Spruyt C, Huisman S, et al. Microbiological outcomes and antibiotic overuse in Emergency Department patients with suspected sepsis[J]. Neth J Med, 2017, 75(5): 196-203.
[29]	Schinkel M, Nannan Panday RS, Wiersinga WJ, et al. Timeliness of antibiotics for patients with sepsis and septic shock[J]. J Thorac Dis, 2020, 12(Suppl 1): S66-S71.
[30]	Nannan Panday RS, Wang S, van de Ven PM, et al. Evaluation of blood culture epidemiology and efficiency in a large European teaching hospital[J]. PLoS One, 2019, 14(3): e0214052.
[31]	Campion M, Scully G. Antibiotic Use in the Intensive Care Unit: Optimization and De-Escalation[J]. J Intensive Care Med, 2018, 33(12): 647-655.
[32]	Opal SM, Garber GE, Larosa SP, et al. Systemic host responses in severe sepsis analyzed by causative microorganism and treatment effects of drotrecogin alfa (activated)[J]. Clin Infect Dis, 2003, 37(1): 50-58.
[33]	Prout AJ, Talisa VB, Carcillo JA, et al. Bacterial and Fungal Etiology of Sepsis in Children in the United States: Reconsidering Empiric Therapy[J]. Crit Care Med, 2020, 48(3): e192-e199.
[34]	Rhee C, Kadri SS, Dekker JP, et al. Prevalence of Antibiotic-Resistant Pathogens in Culture-Proven Sepsis and Outcomes Associated With Inadequate and Broad-Spectrum Empiric Antibiotic Use[J]. JAMA Netw Open, 2020, 3(4): e202899.
[35]	Noll I, Schweickert B, Abu Sin M, et al. [Antimicrobial resistance in Germany. Four years of antimicrobial resistance surveillance (ARS)][J]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2012, 55(11/12): 1370-1376.
[36]	吴健锋，裴飞. 脓毒症免疫治疗的研究现状[J]. 医学研究生学报，2019, 32(1): 37-42.
[37]	张文杰，何英丽，常雪妮，等. 脓毒症治疗新视野：免疫治疗研究进展[J]. 中国实用内科杂志，2019, 39(8): 735-739.
[38]	Fallon EA, Chung CS, Heffernan DS, et al. Survival and Pulmonary Injury After Neonatal Sepsis: PD1/PDL1′s Contributions to Mouse and Human Immunopathology[J]. Front Immunol, 2021, 12: 634529.
[39]	Wilson JK, Zhao Y, Singer M, et al. Lymphocyte subset expression and serum concentrations of PD-1/PD-L1 in sepsis - pilot study[J]. Crit Care, 2018, 22(1): 95.
[40]	Watanabe E, Thampy LK, Hotchkiss RS. Immunoadjuvant therapy in sepsis: novel strategies for immunosuppressive sepsis coming down the pike[J]. Acute Med Surg, 2018, 5(4): 309-315.
[41]	Kim EY, Ner-Gaon H, Varon J, et al. Post-sepsis immunosuppression depends on NKT cell regulation of mTOR/IFN-γ in NK cells[J]. J Clin Invest, 2020, 130(6): 3238-3252.
[42]	Schütze S, Kaufmann A, Bunkowski S, et al. Interferon-gamma impairs phagocytosis of by primary murine peritoneal macrophages stimulated with LPS and differentially modulates proinflammatory cytokine release[J]. Cytokine X, 2021, 3(3): 100057.
[43]	Kox WJ, Bone RC, Krausch D, et al. Interferon gamma-1b in the treatment of compensatory anti-inflammatory response syndrome. A new approach: proof of principle[J]. Arch Intern Med, 1997, 157(4): 389-393.
[44]	Fu J, Yi Z, Cui H, et al. Intein-mediated expression and purification of common carp IFN-γ and its protective effect against spring viremia of carp virus[J]. Fish Shellfish Immunol, 2019, 88: 403-406.
[45]	Monneret G, Venet F. Sepsis-induced immune alterations monitoring by flow cytometry as a promising tool for individualized therapy[J]. Cytometry B Clin Cytom, 2016, 90(4): 376-386.
[46]	Kashiouris MG, L′heureux M, Cable CA, et al. The Emerging Role of Vitamin C as a Treatment for Sepsis[J]. Nutrients, 2020, 12(2): 292.
[47]	吕清泉，顾小花，吕应鸣，等. 维生素C在脓毒症中的应用进展[J/CD]. 中华重症医学电子杂志(网络版), 2020, 6(1): 104-108.
[48]	牛京京，秦秉玉，杨凯丽，等. 早期补充维生素C对脓毒症患者预后的影响[J]. 中国现代医学杂志，2019, 29(23): 65-69.
[49]	Menich BE, Miano TA, Patel GP, et al. Norepinephrine and Vasopressin Compared With Norepinephrine and Epinephrine in Adults With Septic Shock[J]. Ann Pharmacother, 2019, 53(9): 877-885.
[50]	Xing X, Zhi Y, Lu J, et al. Traditional Chinese medicine bundle therapy for septic acute gastrointestinal injury: A multicenter randomized controlled trial[J]. Complement Ther Med, 2019, 47: 102194.
[51]	孙荣青，梁明，杨宏富，等. 血必净对脓毒性休克患者炎症反应及预后的影响[J]. 中华危重病急救医学，2020, 32(4): 458-462.

Please choose a citation manager

Content to export