儿童严重脓毒症及脓毒性休克大量液体复苏的新观点

New insight into fluid bolus resuscitation in pediatric severe sepsis and septic shock

及时识别和治疗儿童脓毒性休克是改善预后,降低病死率的关键。然而,目前仍缺乏儿童脓毒症液体复苏的统一认识。最近关于发热和灌注不足儿童的大量液体复苏的支持疗法研究结果更是引发人们对儿童液体复苏容量治疗的激烈讨论。该文就大量液体复苏的支持疗法的现状和可能机制进行分析。

Early recognition and treatment of pediatric septic shock is key strategy to improve prognosis and reduce the mortality,yet controversy still surrounds the current fluid therapy approach.Recently,the results of the Fluid Expansion as Supportive Therapy （FEAST） trial in African children with severe febrile and hypoperfusion illnesses challenge many established principles about pediatric fluid resuscitation,and lead to intense discussion.This review is to describe the current fluid supportive therapy and possible potential mechanisms of increased death associated with bolus resuscitation.