Sepsis: a roadmap for future research
Sepsis: a roadmap for future research
复制标题
DOI：
10.1016/s1473-3099(15)70112-x
复制
发表时间：
2015-05-01
影响因子：
56.3
通讯作者：
Pelfrene, Eric
中科院分区：
文献类型：
--
作者：
Cohen, Jonathan;Vincent, Jean-Louis;Pelfrene, Eric
脓毒症是一种常见且致命的综合征：尽管结果有所改善，但死亡率仍然很高。没有特定的抗菌治疗;因此，患者的管理主要依赖于早期识别，允许快速开始正确的治疗措施，包括给予适当的抗生素，必要时采取源控制措施，以及在需要时使用静脉输液和血管活性药物进行复苏。虽然在理解脓毒症的基本发病机制以及影响疾病的发病率和病程的宿主、病原体和环境的复杂相互作用方面已经取得了实质性进展，但脓毒症顽固地抵制了成功开发并随后部署新的和改进的治疗方法的所有努力。现有的临床研究模式似乎越来越不可能产生新的治疗方法，从而导致临床结果的阶跃变化。在本委员会中，我们阐述了我们对脓毒症的临床流行病学和管理的理解，然后询问如何挑战目前的方法，为未来的研究制定新的路线图。
Sepsis is a common and lethal syndrome: although outcomes have improved, mortality remains high. No specific anti-sepsis treatments exist; as such, management of patients relies mainly on early recognition allowing correct therapeutic measures to be started rapidly, induding administration of appropriate antibiotics, source control measures when necessary, and resuscitation with intravenous fluids and vasoactive drugs when needed. Although substantial developments have been made in the understanding of the basic pathogenesis of sepsis and the complex interplay of host, pathogen, and environment that affect the incidence and course of the disease, sepsis has stubbornly resisted all efforts to successfully develop and then deploy new and improved treatments. Existing models of clinical research seem increasingly unlikely to produce new therapies that will result in a step change in clinical outcomes. In this Commission, we set out our understanding of the clinical epidemiology and management of sepsis and then ask how the present approaches might be challenged to develop a new roadmap for future research.