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| 1 | AME证据系列001--转化医学协会:脓毒症诊断和早期识别的临床实践指南显示文摘脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。 | Zhongheng Zhang Nathan J.Smischney Haibo Zhang Sven Van Poucke Panagiotis Tsirigotis Jordi Rello Patrick M.Honore Win Sen Kuan Juliet June Ray Jiancang Zhou You Shang Yuetian Yu Christian Jung Chiara Robba Fabio Silvio Taccone Pietro Caironi David Grimaldi Stefan Hofer George Dimopoulos Marc Leone Sang-Bum Hong Mabrouk Bahloul Laurent Argaud Won Young Kim Herbert D.Spapen Jose Rodolfo Rocco 张建成(译) 尚游(译) 钟鸣(校) | 2016 | 临床与病理杂志2016，36，10： | 5 |
| 2 | A European care bundle for prevention of ventilator-associated pneumonia显示文摘 | Jordi Rello Hartmut Lode Giuseppe Cornaglia Robert Masterton | 2010 | Intensive Care Medicine2010，，5： | 2 |
| 3 | Trauma, head injury, and brain in jury infections显示文摘 | Boque MC BodiM Rello J | 2000 | Sem in Respir Infect2000，15，4： | 1 |
| 4 | Continuous aspiration of subglottic secretions in preventing ventilator associated pneumonia 显示文摘 | Valles J Artigas A Rello J | 1995 | Ann Intern Med1995，122，： | 1 |
| 5 | Microbiologically documented nosocomial infections after coronary artery bypass surgery without cardiopulmonary bypass显示文摘 | Falagas ME Rosmarakis ES Rellos K | 2006 | J Thorac Cardiovasc Surg2006，132，： | 1 |
| 6 | Ventilator-associated pneumonia:issues reIated to the artificial airway显示文摘 | Diaz E Rodrigue AH Rello J | 2005 | Respir Care2005，50，7： | 1 |
| 7 | Pedraza S: C-reactive Protein Used as an Early Indicator of Infection in Patients with Systemic Inflammatory Response Syndrome显示文摘 | Sierra R Rello J Bailen M A | 2004 | Intensive Care Med2004，30，： | 1 |
| 8 | Management of communityac- quired pneumonia in adults 显示文摘 | Waterer GW Rello J Wunderink RG | 2011 | Am J Respir Crit Care Med2011，183，2： | 1 |
| 9 | A care bundle approach for prevention of ventilator-associated pneumonia 显示文摘 | Rello J Afonso E Lisboa T | 2013 | C]in Microbiol Infect2013，19，4： | 1 |
| 10 | International conference for the development of consensue on the diagnosis and treatment of ventilator-associated pneumonia显示文摘 | Rello J Paiva A Baraibar J | 2001 | Chest2001，120，： | 1 |
| 11 | The value of routine microbialin vestigation inventilator - associated pneumonia 显示文摘 | Rello J Gallego M Mariscai D | 1997 | Am JR espir Crit Care Med1997，156，： | 1 |
| 12 | International conference for the development of consensus on the diagnosis and treatment of ventilator-associated pneumonia 显示文摘 | Rello J Paiva JA Baraibar J | 2001 | Chest2001，120，3： | 1 |
| 13 | Pneumonia in the intensive care unit 显示文摘 | Rello J Diaz E | 2003 | Crit Care Med2003，31，： | 1 |
| 14 | Ventilator-associated pneumonia:Issues related to the artificial airway显示文摘 | Diaz E Rodrguez AH Rello J | 2005 | Respir Care2005，50，： | 1 |
| 15 | Oral care practices in intensive care units:a survey of 59 European ICUs显示文摘 | Rello J Koulenti D Blot S | | 0，，： | 1 |
| 16 | International study of the prevalence and outcomes of infection in intensive care units 显示文摘 | Vincent JL1 Rello J Marshall J | 2009 | JAMA2009，302，21： | 1 |
| 17 | Pneumonia in intnbat- ed patients: role of respiratory airway care 显示文摘 | Rello J Sofiora R Jubert P | 1996 | Am J Respir Crit Care Med1996，154，9： | 1 |
| 18 | International study of the prevalence and outcomes of infection in intensive care units显示文摘 | Vincent JL Rello J Marshall J | 2009 | JAMA2009，302，21： | 1 |
| 19 | Community - acquired blood- stream infection in critically ill adult patients: impact of shock and in- appropriate antibiotic therapy on survival显示文摘 | Valles J Rello J Ochagavia A | 2003 | Chest2003，123，5： | 1 |
| 20 | Community-acquired bloodstream infection in critically ill adult patients: im- pact of shock and inappropriate antibiotic therapy on sur- vival显示文摘 | Vall6s J Rello J Ochagavia A | 2003 | Chest2003，123，5： | 1 |
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