脓毒性休克血管活性药物临床应用

Clinical application of vasoactive agents for septic shock

在脓毒性休克的救治中,常面临液体复苏无法纠正休克而需使用血管活性药的情况。脓毒性休克时常合并血管舒缩障碍和心功能障碍,且呈动态变化过程,合理使用血管活性药,对改善脓毒性休克患儿的生存率和预后至关重要,对临床医师也具有很大挑战性。针对儿童脓毒性休克时血流动力学特点及其评估方法,以及血管活性药的临床应用进行讨论很有必要。

During resuscitation of septic shock in children, vasoactive agents are often needed because of failure of fluid resuscitation. Abnormal vasoconstriction and vasodilation and myocardial dysfunction are commonly seen in children with septic shock, which is dynamic. Rational use of vasoactive and inotropic agents is very important to improve survival and prognosis of patients with septic shock and it is also quite challenging to clinical doctors. In this article the characteristics and monitoring of hemodynamics and therapeutic use of vasoactive agents in children with septic shock are discussed.