Tóm tắt
Mặc dù đã có nhiều tiến bộ trong thực hành cấp cứu và hồi sức tích cực, tỷ lệ tử vong của bệnh nhân sốc nhiễm khuẩn vẫn còn rất cao. Sốc nhiễm khuẩn được đặc trưng bởi sự giãn mạch hệ thống và rò mao mạch phát sinh từ viêm toàn thân do nhiễm trùng nghiêm trọng. Bên cạnh các phương pháp điều trị cụ thể bao gồm kháng sinh và loại bỏ nguồn nhiễm trùng, việc phục hồi hiệu quả rối loạn huyết động và hỗ trợ cơ quan đóng vai trò rất quan trọng. Nói chung, trước hết cần phải bù dịch tĩnh mạch, sau đó sử dụng thuốc vận mạch khi tối ưu đã thể tích nội mạch nhưng không đạt được mục tiêu huyết áp. Can thiệp sớm đã được chứng minh cải thiện nhanh kết quả điều trị. Vì giảm trương lực mạch máu là một dấu hiệu đặc trưng của sốc nhiễm khuẩn, nên việc sử dụng norepinephrine là hợp lý. Tuy nhiên, việc sử dụng sớm thuốc vận mạch cụ thể là norepinephrine trong sốc nhiễm khuẩn vẫn còn gây tranh cãi. Bài tổng quan này cung cấp những lập luận lý giải cho việc sử dụng sớm norepinephrine - thuốc vận mạch đầu tay được khuyến nghị - trong sốc nhiễm khuẩn.
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| Đã xuất bản | 02-03-2025 | |
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| Số tạp chí | Số 87 (2023) | |
| Phân mục | Tổng quan | |
| DOI | 10.38103/jcmhch.87.18 | |
| Từ khóa | Sử dụng norepinephrine sớm, quá tải dịch, nhiễm khuẩn huyết, sốc nhiễm khuẩn. Early norepinephrine, fluid overload, sepsis, septic shock |
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