Sepsis in the burn patient:a different problem than sepsis in the general population

作     者：David G. Greenhalgh 

作者机构：Shriners Hospitals for Children Northern California 2425 Stockton Blvd. Sacramento CA 95817 USA Firefighters Regional Burn Center at University of California Davis USA Department of Surgery University of California Davis USA 

出 版 物：《Burns & Trauma》 (烧伤与创伤（英文）)

年 卷 期：2017年第5卷第3期

页      面：148-157页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 1011[医学-护理学（可授医学、理学学位）] 100214[医学-肿瘤学] 0836[工学-生物工程] 10[医学] 

主　　题：Sepsis Septic shock Infection Inflammation Burns Pediatric Multiple organ dysfunction syndrome 

摘      要：Sepsis has recently been defined as life-threatening organ dysfunction caused by a dysregulated host response to infection . A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns. The reason for the exclusion is that the sepsis found in burn patients is different than that of the general population. The early treatment strategies, such as those directed by the Surviving Sepsis Campaign, focus on patients presenting to hospitals with recent signs of infection. Burn patients lose their primary barrier to infection, the skin, and thus the risk of infection persists as long as that barrier is absent. Efforts have been made to define sepsis, septic shock and infection in the burn population but there is constant need for revisions. One focus of this review is to discuss the differences in burn sepsis versus sepsis of the general population. Children often have profound responses to sepsis but can also make remarkable recoveries. This review will also explore problems specific to pediatric burns. The treatment of burns requires a continuous vigilance to watch for the subtle early signs of sepsis and then expeditious initiation of aggressive therapy. Strategies covering optimal management of pediatric burn sepsis will also be summarized.