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引用次数: 0
摘要
败血症的死亡率居高不下,如果并发弥散性血管内凝血(DIC),死亡率还会进一步上升。因此,及早发现并适当处理 DIC 将有助于败血症的治疗。虽然显性 DIC 标准通常用于诊断明确的 DIC,但其设计目的并非是为了检测早期阶段的 DIC。脓毒症诱发凝血病(SIC)的标准和评分系统于 2017 年制定并推出,用于检测早期 DIC,随后于 2019 年被国际血栓与止血学会采用。检测 SIC 的目的是不遗漏早期发展为明显 DIC 的高风险患者。虽然抗凝疗法是治疗脓毒症相关 DIC 的潜在选择,但其有效性尚未确定,因此需要进一步研究。为此,需要为未来的临床试验建立一个国际合作平台,并为此类研究提出了 SIC 标准。SIC 评分的计算简单明了,适合在临床环境中使用。本综述旨在介绍 SIC 标准及其评分系统,以便更好地管理脓毒症相关 DIC。我们还打算更新有关这一新型诊断标准的现有知识。
Sepsis-induced coagulopathy (SIC) in the management of sepsis.
The mortality rate of sepsis remains high and further increases when complicated by disseminated intravascular coagulation (DIC). Consequently, early detection and appropriate management of DIC will be helpful for the management of sepsis. Although overt DIC criteria are often used for diagnosing definitive DIC, it was not designed to detect early-phase DIC. The criteria and scoring system for sepsis-induced coagulopathy (SIC) were developed and introduced in 2017 to detect early-stage DIC, and they were subsequently adopted by the International Society on Thrombosis and Haemostasis in 2019. The objective of detecting SIC was not to miss the patients at high risk of developing overt DIC at an earlier time. Although anticoagulant therapies are potential options for the treatment of sepsis-associated DIC, their effectiveness has not been established, and further research is warranted. For that purpose, an international collaborative platform is required for future clinical trials, and SIC criteria have been suggested for such studies. Calculating the SIC score is straightforward and suitable for use in clinical settings. This review aims to introduce SIC criteria and its scoring system for better management of sepsis-associated DIC. We also intended to update the current knowledge regarding this novel diagnostic criterion.
期刊介绍:
Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.