麻醉和手术期间的危机管理。第XV部分:败血症

S. A, Jasim M Salman A
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引用次数: 0

摘要

精神状态改变——呼吸急促发热(>38.3°C)或体温过低(核心温度<36°C)心率>90/min动脉性低血压(sBP<90mmHg)动脉性低氧血症(PaO2/FiO2<300)毛细血管充盈减少或斑点状急性少尿(尽管进行了充分的液体复苏,但尿量<0.5ml/kg/hr至少持续2小时)Ileus(肠鸣音缺失)明显水肿或液体平衡良好(24小时内>20 mL/kg)在没有糖尿病白细胞增多症(WBC计数>1000/μl)的情况下出现高血糖(血糖>140 mg/dl),白细胞减少症(WBC计数<4000/μl)或正常WBC计数大于10%的未成熟形式高血清肌酐高血浆C反应性凝血异常(INR>1.5或PTT>60秒)血小板减少症(血小板计数4mg/dl)不明代谢性酸中毒弥散性血管内凝血病的证据术后呼吸衰竭无法逆转
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MANAGEMENT OF CRISES DURING ANESTHESIA AND SURGERY. PART XV: SEPSIS
Altered mental status Tachypnea Fever (> 38.3°C) or Hypothermia (core temperature < 36°C) Heart rate > 90/min Arterial hypotension (sBP < 90 mmHg) Arterial hypoxemia (PaO2/FiO2 < 300) Decreased capillary refill or mottling Acute oliguria (urine output < 0.5 ml/kg/hr for at least 2 hrs despite adequate fluid resuscitation) Ileus (absent bowel sounds) Significant edema or positive fluid balance (> 20 mL/kg over 24 hours) Hyperglycemia (plasma glucose >140 mg/dl) in the absence of diabetes Leukocytosis (WBC count >12,000/μl), leukopenia (WBC count < 4,000/μl) or normal WBC count with greater than 10% immature forms High serum creatinine High Plasma C-reactive Coagulation abnormalities (INR >1.5 or a PTT >60 sec) Thrombocytopenia (platelet count <100,000/μl) Hyperbilirubinemia (plasma total bilirubin >4 mg/dl) Unexplained metabolic acidosis Evidence of disseminated intravascular coagulopathy Postoperative respiratory failure Failure to reverse
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