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Sepsis - Update 2026

delete2026-07-01
delete1
PRE
AI
L
Lina-Hanne Maria Ko *
A
Axel Nierhaus
K
Kluge, Stefan
DOI：10.1055/a-2853-3828delete
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摘要

摘要

En 中文
脓毒症仍然是院内死亡的主要原因，并在肺脏病学中构成特殊挑战，因为呼吸系统在多达50%的病例中受累。在德国，每年约有27.9万名患者发生脓毒症，据报道院内死亡率接近40%，具体取决于数据来源和病例构成。诊断延迟与较差预后相关，强调了结构化早期识别、指南导向治疗和质量保证措施的重要性。当前的脓毒症-3定义将脓毒症描述为一种危及生命的器官功能障碍，由感染引起的主机反应失调所致，通过SOFA评分增加≥2分来诊断。脓毒性休克定义为尽管液体复苏充分仍持续低血压，乳酸水平>2 mmol/L，以及需要血管加压药以维持平均动脉压≥65 mmHg。自2026年初以来，已实施全国性质量保证程序，涵盖筛查率、抗生素给药、标准化治疗流程和医务人员培训，旨在改善流程质量和患者预后。更新的2025年德国脓毒症指南推荐使用NEWS2评分作为qSOFA的替代方案，因其简单性和临床实用性，两者均被纳入质量保证程序。当怀疑脓毒症时，也建议早期测量乳酸。抗菌治疗前应采集至少两套血培养。脓毒性休克时，抗生素应在1小时内启动；脓毒症但无脓毒性休克时，应在3小时内启动。初始血流动力学稳定包括在前3小时内给予30 ml/kg的平衡晶体液。若低血压持续，去甲肾上腺素是首选血管加压药。指南进一步强调结构化脓毒症后护理。幸存者应及早被告知潜在长期后遗症，包括重症监护后综合征（PICS），并通过协调的出院计划和随访获得支持。
Keyword:
sepsis
quality assurance procedure
updated German S3 guideline
sepsis
quality assurance procedure
updated German S3 guideline

期刊

P
Pneumologie
IF:
1.7
论文数:
592
被引数:
0

机构

U
university of hamburg
学者数:
3.7W
论文数: 2.9W
被引数: 30
引用论文

引用论文

Accuracy of Quick Sequential Organ Failure Assessment Score to Predict Sepsis Mortality in 121 Studies Including 1,716,017 Individuals
errCritical Care Explorations
IF0
err2019-09-01
err0
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errVelma Herwanto; Amith Shetty; Marek Nalos; Mandira Chakraborty; Anthony McLean; Guy D. Eslick; Benjamin Tang
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Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score序贯器官衰竭评估(SOFA)-2评分的开发与验证
errJAMA
IF0
err2025-12-16
err0
PREAI
errRanzani,Otavio T.; Singer,Mervyn; Salluh,Jorge I. F.; Shankar-Hari,Manu; Pilcher,David; Berger-Estilita,Joana; Coopersmith,Craig M.; Juffermans,Nicole P.; Laffey,John; Reinikainen,Matti; Neto,Ary Serpa; Tavares,Miguel; Timsit,Jean-François; Arias Lopez,Maria Del Pilar; Arulkumaran,Nish; Aryal,Diptesh; Azoulay,Elie; Celi,Leo Anthony; Chaudhuri,Dipayan; De Lange,Dylan; De Waele,Jan; Dos Santos,Claudia C.; Du,Bin; Einav,Sharon; Engelbrecht,Teresa; Fazla,Fathima; Ferrer,Ricard; Finazzi,Stefano; Fujii,Tomoko; Gershengorn,Hayley B.; Greene,John D.; Haniffa,Rashan; Hao,Sicheng; Hasan,Mohd Shahnaz; Hollenberg,Steve; Ippolito,Mariachiara; Jung,Christian; Kirov,Mikhail; Kobari,Shigetaka; Lakbar,Inès; Lipman,Jeffrey; Liu,Vincent; Liu,Xiaoli; Lobo,Suzana M.; Magatti,Demetrio; Martin,Greg S.; Metnitz,Barbara; Metnitz,Philipp; Myatra,Sheila N.; Oczkowski,Simon; Paiva,José-Artur; Paruk,Fathima; Pekkarinen,Pirkka T.; Piquilloud,Lise; Pölkki,Anssi; Prescott,Hallie C.; Blaser,Annika Reintam; Rezende,Ederlon; Robba,Chiara; Rochwerg,Bram; Ruckly,Stephane; Samei,Rasoul; Schenck,Edward J.; Secombe,Paul; Sendagire,Cornelius; Siaw-Frimpong,Moses; Simpkin,Andrew J.; Soares,Márcio; Summers,Charlotte; Szczeklik,Wojciech; Takala,Jukka; Tanaka,Shiro; Tricella,Giovanni; Vincent,Jean-Louis; Wendon,Julia; Zampieri,Fernando G.; Rhodes,Andrew; Moreno,Rui
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Challenges in assessing the burden of sepsis and understanding the inequalities of sepsis outcomes between National Health Systems: secular trends in sepsis and infection incidence and mortality in Germany
errINTENSIVE CARE MEDICINE
IF21.2
err2018-10-04
err83
errOAAI
errFleischmann-Struzek, C.; Mikolajetz, A.; Schwarzkopf, D.; Cohen, J.; Hartog, C. S.; Pletz, M.; Gastmeier, P.; Reinhart, K.
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Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014使用临床vs索赔数据的美国医院败血症的发病率和趋势，2009-2014
errJAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
IF55
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errRhee, Chanu; Dantes, Raymund; Epstein, Lauren; Murphy, David J.; Seymour, Christopher W.; Iwashyna, Theodore J.; Kadri, Sameer S.; Angus, Derek C.; Danner, Robert L.; Fiore, Anthony E.; Jernigan, John A.; Martin, Greg S.; Septimus, Edward; Warren, David K.; Karcz, Anita; Chan, Christina; Menchaca, John T.; Wang, Rui; Gruber, Susan; Klompas, Michael
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Enhancing Recovery From Sepsis A Review增强败血症的恢复
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IF55
err2018-01-02
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errPrescott, Hallie C.; Angus, Derek C.
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Sepsis Alert Systems, Mortality, and Adherence in Emergency Departments A Systematic Review and Meta-Analysis急诊部门的脓毒症警报系统，死亡率和依从性系统回顾和荟萃分析
errJAMA NETWORK OPEN
IF9.7
err2024-07-22
err2
errOAAI
errKim, Hyung-Jun; Ko, Ryoung-Eun; Lim, Sung Yoon; Park, Sunghoon; Suh, Gee Young; Lee, Yeon Joo
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Procalcitonin-guided antibiotic therapy may shorten length of treatment and may improve survival-a systematic review and meta-analysis降钙素原指导的抗生素治疗可能缩短治疗时间并可能改善生存-系统回顾和荟萃分析
errCRITICAL CARE
IF9.3
err2023-10-13
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errPapp, Marton; Kiss, Nikolett; Baka, Mate; Trasy, Domonkos; Zubek, Laszlo; Fehervari, Peter; Harnos, Andrea; Turan, Caner; Hegyi, Peter; Molnar, Zsolt
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Albumin Replacement Therapy in Septic Shock萨克拉, Y.; 尼尔豪斯, A.; 修姆巴赫, U.; 乌托利诺, S.; 雅施辛斯基, U.; 佩特罗斯, S.; 菲希特纳, F.; 埃默, C.; 普特森森, C.; 塔内夫, I.; 等. 白蛋白替代疗法在脓毒性休克中的应用：一项随机临床试验. JAMA Netw. Open 2026, 9, e2559297. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
errJAMA Network Open
IF0
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err0
PREAI
errSakr,Yasser; Nierhaus,Axel; Schumacher,Ulrike; Utzolino,Stefan; Jaschinski,Ulrich; Petros,Sirak; Fichtner,Falk; Eimer,Christine; Putensen,Christian; Tanev,Ivan; Kreienbühl,Lukas; Kluge,Stefan; Kousoulas,Lampros; Kuhn,Sven-Olaf; Jarczak,Dominik; Quintel,Michael; Bauer,Michael; ; Appelt,Peter; Becher,Tobias; Bischoff,Petra; Briegel,Josef M.; Deetjen,Phillipp; Ebbinghaus,Jahn; Ehrentraut,Stefan; Elke,Gunnar; Fiedler,Fritz; Frank,Sandra; Fritzenwanger,Michael; Gattinoni,Luciano; Günther,Ulf; Handerer,Immanuel J.; Frey,Ulrich H.; Holubek,Marie; Jacob,David; Kapfer,Barbara; Lautenschläger,Ingmar; Lehmke,Josefa; Lindner,Matthias; Lodes,Uwe; Martin,Jan; Meersch-Dini,Melanie; Michalski,Dominik; Mörer,Onnen; Pasieka,Bastian; Pfeifer,Rüdiger; Rasche,Stefan; Roghmann,Florian; Scheer,Christian; Schering,Stefan; Schewe,Jens-Christian; Schmeisser,Alexander; Schulze,Christian; Senkal,Metin; Simon,Philipp; Tepaß,Petra; Wartenberg,Katja; Weidhase,Lorenz; Weissbrich,Carsten; Westphal,Julian; Weyland,Andreas; Zarbock,Alexander
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Sepsis Outcome after Major Abdominal Surgery Does Not Seem to Be Improved by the Use of Pentameric Immunoglobulin IgM: A Single-Center Retrospective Analysis
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