脓毒症 3.pptxVIP

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3);The history of Sepsis/MODS ;Background;Background ;Background;Consensus from 1991 to 2001;Sepsis definitions: time for change ;The reported incidence of sepsis is increasing;New 3-Year and 5-Year Survivors After Severe Sepsis ;Sepsis definitions: time for change ;Sepsis1.0;Sepsis1.0;Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis;Infectious and non-infectious stimuli that activate innate immunity and cytokine release and can cause sepsis ;Systemic Inflammatory Response Syndrome Criteria in Defining Severe Sepsis;Sepsis1.0、 2.0;The SIRS approach has three major problems ;Sepsis;Hi SOFA（Organ Dysfunction or Failure）;专家组认为，当SOFA评分≥2时，可以认为是感染患者出现了器官衰竭的急性变化——也就是Sepsis，可以反映约10%的综合医院疑似感染患者的总死亡风险。 然而SOFA量表中许多指标是需要化验的，而且SOFA量表大多用于重症医学科的患者，其他科室用得很少。那么哪些指标是最容易体现疑似感染患者的不良预后（ICU住院天数＞3或病死）呢？进行大数据分析后发现3个数据脱颖而出：收缩压（SBP）≤100 mmHg、呼吸频率≥22次/min、意识改变，这3个数据被称为qSOFA（Quick SOFA）。虽然精准度上不及SOFA，但qSOFA可以快速评估那些疑似感染患者有Sepsis的可能，能够提醒临床医务人员哪些患者需要进一步的监护，从而及时干预。;Definition of Sepsis;Terminology and International Classification of Diseases Coding;Operationalization of Clinical Criteria Identifying Patients With Sepsis and Septic Shock;Thanks for your attention