Importance of timely and adequate source control in sepsis and septic shock  

作　　者：Jan J.De Waele 

机构地区：[1]Department of Intensive Care Medicine,Ghent University Hospital,Ghent,Belgium [2]Department of Internal Medicine and Pediatrics,Faculty of Medicine and Health Sciences,Ghent University,Ghent,Belgium

出　　处：《Journal of Intensive Medicine》2024年第3期281-286,共6页重症医学（英文）

基　　金：supported by the Research Foundation Flanders(grant number 1881020N).

摘　　要：Source control is defined as the physical measures undertaken to eliminate the source of infection and control ongoing contamination, as well as restore anatomy and function at the site of infection. It is a key component of the management of patients with sepsis and septic shock and one of the main determinants of the outcome of infections that require source control. While not all infections may require source control, it should be considered in every patient presenting with sepsis;it is applicable and necessary in numerous infections, not only those occurring in the abdominal cavity. Although the biological rationale is clear, several aspects of source control remain under debate. The timing of source control may impact outcome;early source control is particularly relevant for patients with abdominal infections or necrotizing skin and soft tissue infections, as well as for those with more severe disease. Percutaneous procedures are increasingly used for source control;nevertheless, surgery—tailored to the patient and infection—remains a valid option for source control. For outcome optimization, adequate source control is more important than the strategy used. It should be acknowledged that source control interventions may often fail, posing a challenge in this setting. Thus, an individualized, multidisciplinary approach tailored to the infection and patient is preferable.

关 键 词：SEPSIS Septic shock Source control Drainage DEBRIDEMENT 

分 类 号：R515.3[医药卫生—内科学]