European Society Intensive Care Medicine и Society Critical Care Medicine: 6 ключевых положений по ведению пациентов с сепсисом. Куда идем дальше?
https://doi.org/10.21292/2078-5658-2020-17-6-54-62
Аннотация
Цель: анализ обоснованности рекомендаций специального научного комитета European Society Intensive Care Medicine (ESICM) и Society Critical Care Medicine (SCCM), касающихся наиболее важных положений по ведению пациентов c сепсисом и септическим шоком, с выделением предикторов долгосрочной нуждаемости в оказании медицинской помощи и летальности.
Материалы и методы. Выполнен анализ источников литературы, на основании которых экспертами по ведению больных сепсисом выделены ключевые положения рекомендаций.
Результаты. Акцентировано внимание на шести положениях: эмпирическая комбинированная антибиотикотерапия, индивидуальная по объему инфузия, быстрая диагностика инфекции, оценка органно-системной дисфункции, выделение предикторов долгосрочной нуждаемости в оказании медицинской помощи и летальности, попытки внедрения и перспективы точной/персонализированной медицины. Показано, что значения шкалы SOFA, ЧСС, сист.АД, содержание лактата и альбумина должны отражать сбалансированность групп по данным параметрам. Молекулярная классификация больных с сепсисом, предусматривающая наличие различных эндотипов, создает условия для лучшей селекции пациентов в клинических исследованиях.
Ключевые слова
Об авторах
В. А. РудновРоссия
Руднов Владимир Александрович доктор медицинских наук, профессор
620102, г. Екатеринбург, ул. Волгоградская, д. 189
Тел.: +7 (343) 266‒95‒06
В. А. Багин
Россия
Багин Владимир Анатольевич заведующий отделением анестезиологии и реанимации.
620102, г. Екатеринбург, ул. Волгоградская, д. 189
Тел.: +7 (343) 266‒95‒03
М. Н. Астафьева
Россия
Астафьева Мария Николаевна врач отделения анестезиологии и реанимации
620102, г. Екатеринбург, ул. Волгоградская, д. 189
Тел.: +7 (343) 266‒95‒03
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Рецензия
Для цитирования:
Руднов В.А., Багин В.А., Астафьева М.Н. European Society Intensive Care Medicine и Society Critical Care Medicine: 6 ключевых положений по ведению пациентов с сепсисом. Куда идем дальше? Вестник анестезиологии и реаниматологии. 2020;17(6):54-62. https://doi.org/10.21292/2078-5658-2020-17-6-54-62
For citation:
Rudnov V.A., Bagin V.A., Аstafieva M.N. European Society of Intensive Care Medicine и Society of Critical Care Medicine: 6 key provisions for management of sepsis patients. Where do we go next? Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2020;17(6):54-62. (In Russ.) https://doi.org/10.21292/2078-5658-2020-17-6-54-62