脓毒症j宣教培训课件.ppt

严重脓毒症及脓毒性休克流行病学新近流调显示脓毒性休克死亡率下降脓毒症定义变迁（1.0）脓毒症定义变迁（2.0）DiagnosticcriteriaforsepsisThePIROsystemforstagingsepsis2012脓毒症诊断标准的“争议”Doweneedanewdefinitionofsepsis?Sepsis3.0“应运而生”Sepsis3.0定义Sepsis3.0＝Infection＋SOFA≥2Septicshock定义及诊断标准脓毒症3.0诊断流程Sepsis3.0ACCP反对Sepsis3.0ACCP反对Sepsis3.0精准医学下的Sepsis3.0不足“DependentandIndependentVariables”.
Sepsis=ƒ[(life-threatening)(organdysfunction)(dysregulatedhostresponse)(infection)].
(1)Don’tassumethatthesequenceofeventsidentifiedinthenewdefinitionreflectspathobiologicalreality,becausenoonereallyknowshowthingsareorderedandconnected;
(2)Don’tassumethatthepredominantabnormalityinsepsisisimmunological–thathypothesishasdominatedbothmechanisticandtherapeuticinvestigationforovertwodecades,andhasyettobearfruit.精准医学下的Sepsis3.0不足22Problem#1:Sepsis-IIIremainssubjectiveProblem#2:qSOFA&SOFAaremortalitypredictors,nottestsforsepsisProblem#3:Sepsis-IIIislessspecificforinfectionthanSepsis-IIProblem#4:qSOFAhassimilarperformancecomparedtoSIRSformortalitypredictionProblem#5:qSOFAmaybelessspecificindiseasesthatdirectlycausehypotension,tachypnea,ordeliriumSepsis3.0的10个疑问（六）Sepsis3.0的10个疑问（七）Sepsis3.0的10个疑问（八）Sepsis3.0的10个疑问（九）Sepsis3.0的10个疑问（十）脓毒症未来发展BMJ：Sepsis的病理生理及临床治疗BMJ:当前证据下的脓毒症诊治“取舍”脓毒症未来发展方向Howdoesthemicrobiomechangeinsepsisandhowmightthisbeleveragedtherapeutically?SEPSIS中微生物如何变化及如何因此调整治疗？
Whatarethelongtermphysical,cognitive,andpsychosocialchangesinpatientswhosurvivesepsis,andcanwedevelopeffectiverehabilitativetechniques?SEPSIS存活者长期的躯体、认知、心里有何变化？有效康复技术？
Canweimprovetheabilityofpreclinicalmodelsofsepsistopredicttherapeuticefficacy?改善SEPSIS临床前模型能力，预测治疗效果
Canwedeveloparangeofpoint-of-carebiomarkerstogrouppatientswithsepsisintopathophysiologiccategories?Thiswouldimproveourunderstandingofthebiologyandmayenhanceclinicaltrialdesign能通过生物标志物对SEPSIS患者进行病理生理归类，从而加深认识提高临床研究的设计？
Howwilltherecentlyreleaseddefinitionsandclinicalcriteriaforsepsisshapeitsclinicaldetection,treatment,andresearch?新标准对诊断、治疗、研究的影响？小结谢谢