在资源有限的环境中管理成人败血症:使用德尔菲方法的全球专家共识陈述
Louise Thwaites1, Prashant Nasa2,3, Brett Abbenbroek4,5
1Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
Intensive care medicine
|December 23, 2024
概括
专家共识为资源有限的环境中成人败血症管理提供临床实践陈述. 这些指导方针涉及复苏,流体管理,血管压缩剂的使用和当先进的设施无法使用时的抗菌药物管理.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 全球健康 全球健康
背景情况:
- 败血症管理指南往往缺乏针对资源有限的环境的具体建议.
- 需要为临床医生提供实际的,基于证据的指导,这些领域的临床医生对先进的诊断和监测的访问有限.
研究的目的:
- 为在资源有限的环境中为成年人败血症管理提供临床实践陈述产生专家共识.
- 提供实际指导,补充现有的国际指导方针.
主要方法:
- 一个国际的多学科指导委员会召开了亚太败血症联盟 (APSA).
- 为了达成共识,使用了涉及国际败血症专家的德尔菲过程.
- 为了完成30个实践陈述,进行了四轮调查.
主要成果:
- 在关键护理区域以外的败血症管理,升级触发因素和安全转移标准方面达成了共识.
- 临床参数 (精神状态,毛细血管补充,尿液输出) 可以指导乳酸缺乏的复苏.
- 建议包括平衡的盐溶液,外围血管压缩剂的使用,以及经验性抗微生物/抗寄生素药物.
结论:
- 在资源有限的环境中治疗败血症的30个临床实践陈述上达到了专家的共识.
- 这些陈述解决了证据缺口,并为具有挑战性的环境提供了实际解决方案.
- 需要进一步的研究来评估这些实践陈述的影响.
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