2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
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DOI：
10.1097/01.ccm.0000050454.01978.3b
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发表时间：
2003-04-01
影响因子：
8.8
通讯作者：
Ramsay, G
中科院分区：
文献类型：
--
作者：
Levy, MM;Fink, MP;Ramsay, G
目的：1991年，美国胸科医师学会(ACCP)和重症监护医学会(SCCM)召开了一次“共识会议”，会议的目标是“提供一个概念性和实践性的框架来定义全身对感染的炎症反应，感染是一种进行性的损伤过程，属于广义的‘脓毒症’，也包括败血症相关的器官功能障碍。”这次会议提出的一般定义在实践中得到了广泛应用，并成为许多治疗干预临床试验纳入标准的基础。然而，该领域的专家一直在推动修改这些定义，以反映我们目前对这些综合征的病理生理学的理解。设计：几个北美和欧洲的重症监护学会同意重新考虑脓毒症和相关疾病的定义。本次会议由SCCM、欧洲重症监护医学学会(ESICM)、美国胸科医师学会(ACCP)、美国胸科学会(ATS)和外科感染学会(SIS)联合主办。来自欧洲和北美的29名与会者出席了会议。在会议之前，成立了五个小组来评估以下领域：脓毒症的体征和症状、细胞标志物、细胞因子、微生物学数据和凝血参数。各分组在会议前进行了电子通信，并在会议期间面对面进行了会晤。每个小组的发言人在全体会议期间向所有与会者介绍了每个小组的审议情况。会议上成立了一个写作委员会，并根据每个小组和全体小组发言产生的执行摘要文件编写了目前的这篇文章。本文是2001年国际脓毒症定义会议的最终报告。本文件反映了一个过程，一组专家和意见领袖重新审查了1992年的脓毒症指南，发现除了扩大脓毒症的体征和症状清单以反映临床床边经验外，没有证据支持更改定义。这种证据的缺乏突出了2003年临床医生和研究人员在诊断脓毒症方面仍然存在的挑战，也为引入PIRO作为未来研究的假设生成模型提供了基础。
Objective: In 1991, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) convened a "Consensus Conference," the goals of which Were "to provide a conceptual and a practical framework to define the systemic inflammatory response to infecton, which is a progressive injurious process that falls under the generalized term 'sepsis' and includes sepsis-associated organ dysfunction as well." The general definitions introduced as a result of that conference have been widely used in practice and have served as the foundation for inclusion criteria for numerous clinical trials of therapeutic interventions. Nevertheless, there has been an impetus from experts in the field to modify these definitions to reflect our current understanding of the pathophysiology of these syndromes.Design: Several North American and European intensive care societies agreed to revisit the definitions for sepsis and related conditions. This conference was sponsored by the SCCM, The European Society of Intensive Care Medicine (ESICM), The American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Surgical Infection Society (SIS).Methods. The conference was attended by 29 participants from Europe and North America. In advance of the conference, five subgroups were formed to evaluate the following areas: signs and symptoms of sepsis, cell markers, cytokines, microbiologic data, and coagulation parameters. The subgroups corresponded electronically before the conference and met in person during the conference. A spokesperson for each group presented the deliberation of each group to all conference participants during a plenary session. A writing committee was formed at the conference and developed the current article based on executive summary documents generated by each group and the plenary group presentations. The present article serves as the final report of the 2001 International Sepsis Definitions Conference.Conclusion. This document reflects a process whereby a group of experts and opinion leaders revisited the 1992 sepsis guidelines and found that apart from expanding the list of signs and symptoms of sepsis to reflect clinical bedside experience, no evidence exists to support a change to the definitions. This lack of evidence serves to underscore the challenge still present in diagnosing sepsis in 2003 for clinicians and researchers and also provides the basis for introducing PIRO as a hypothesis-generating model for future research.