新光醫院感染科敗血症951005.ppt

新光醫院感染科敗血症標準作業流程severe sepsis and septic shock;SEPSIS;1. 敗血症的定義;ETIOLOGY;Sepsis;Definitions Used to Describe the Condition of Septic Patients;Epidemiology of Sepsis in the United States from 1979-2000;EPIDEMIOLOGY;EPIDEMIOLOGY;PATHOPHYSIOLOGYEndotoxin;PATHOPHYSIOLOGYMicrobial signals;敗血症的症狀;CLINICAL MANIFESTATIONS;CLINICAL MANIFESTATIONS;LABORATORY FINDINGS;LABORATORY FINDINGS;LABORATORY FINDINGS;Multiple organ dysfunction syndrome;DIAGNOSIS;DIAGNOSIS;TREATMENT;TREATMENT;PROGNOSIS;2.敗血症初期之緊急處理;2.敗血症初期之緊急處理;2.敗血症初期之緊急處理;3.抗生素療法 ;3.抗生素療法;4 控制病源;5 輸液治療;6 血管收縮劑;7 升壓劑(Dobutamine);8 類固醇;9 人類活性C蛋白使用;10 血類製劑 ;11 呼吸器使用;12 鎮靜劑麻醉藥品及肌肉鬆弛劑使用;13 血中葡萄糖控制;14 碳酸鹽治療;15 預防壓力性腸胃道潰瘍;16 褥瘡之預防;Epidemiology of Sepsis in the United States from 1979-2000;Antimicrobial Agents in the Management of Sepsis;Norepinephrine 4 mg/4 ml/amp (diluted by D5W) - 0.03~3.3 μg/kg/min (2~200 μg/kg/hr) Epinephrine 1 mg/1 ml/amp - 0.06~0.47 μg/kg/min (3.6~30 μg/kg/hr) Dopamine 200 mg/5 ml/amp 2~55 μg/kg/min (0.12~3.3 mg/kg/hr) Dobutamine 250 mg/20 ml/amp 2~28 μg/kg/min (0.12~1.68 mg/kg/hr) Vasopressin 20 U/1 ml/amp 0.01~0.04 U/min (0.6~2.4 U/hr);Role of Corticosteroid in the Management of Septic Shock;Crit Care Med 2004; 32: 858-73.;Mechanical Ventilation of Sepsis-induced ALI/ARDS;Intensive Insulin in Critical Ill Patients;Intensive Insulin in Critical Ill Patients;Intensive Insulin in Critical Ill Patients;Advances in Therapy for Severe Sepsis and Septic Shock;Thanks for Your Attention