感染与多器官功能障碍

/年?死亡 1400/天РMODS病死率Р总死亡率:70%?2个器官衰竭:45~55%?涉及肺或肾脏:>80%?3个器官持续>7d: ~100%?ICU非急性死亡的主要原因РOutlineРIntroduction?Mechanism?Criteria?Clinical manifestation?TreatmentРWorld War One?循环衰竭,低容量休克РWorld War Two?Korean War?创伤后急性肾衰РViet Nam War? 创伤后急性呼吸功能不全РSeventy’s?综合征Р1991?an dysfunction syndromeРMultiple an failure. ?The role of uncontrolled infection .РThey studied multiple parameters in ? 553 consecutive emergency surgical? patients.?MSOF is primarily due to infection.?MSOF is the mon fatal ? expression of uncontrolled infection.Р1980,115(2):136-140.РMODS病因РMODS病因Р非感染Р感染因素:70-85%?50%肺 40%腹腔 10%其他Р二次打击学说Р一次打击Р活化炎症细胞РSIRSР二次打击:感染Р过度活化炎症细胞Р不能控制的SIRSРMODSР概念РInfection?Sepsis?Severe Sepsis?Septic Shock?Systemic Inflammatory Response Syndrome(SIRS)?an Dysfunction Syndrome(MODS)?Multiple an Failure(MSOF)