๋น„์ „ํ˜• ํŒจํ˜ˆ์ฆ / Atypical sepsis

์ •์˜

๋น„์ „ํ˜• ํŒจํ˜ˆ์ฆ์€ ๋ฐœ์—ด, lactate ์ƒ์Šน, ์ „ํ˜•์  ๊ฐ์—ผ ์ง•ํ›„๊ฐ€ ๋šœ๋ ทํ•˜์ง€ ์•Š๊ฑฐ๋‚˜ ๊ณ ๋ นยท๋ฉด์—ญ์ €ํ•˜ ๋“ฑ ํŠน์ˆ˜๊ตฐ์—์„œ ๋‹ค๋ฅด๊ฒŒ ๋‚˜ํƒ€๋‚˜๋Š” sepsis ํ‘œํ˜„ํ˜•์ด๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

์‘๊ธ‰์‹ค์—์„œ ๋งค์ผ ๋ฐœ์ƒํ•˜๊ณ  ์‚ฌ๋ง๋ฅ  outcome์ด ๋ช…ํ™•ํ•ด ์ž„์ƒ ์—ฐ๊ตฌ ์ฃผ์ œ๋กœ ๊ฐ•ํ•˜๋‹ค. ๊ณ ๋ น sepsis, afebrile sepsis, immunocompromised host, lactate-negative shock์ด ํ•ต์‹ฌ ํ•˜์œ„ ์ฃผ์ œ๋‹ค. Bacteremia prediction๋„ ์‘๊ธ‰์‹ค ์—ฐ๊ตฌ ์งˆ๋ฌธ์ด ๋  ์ˆ˜ ์žˆ๋‹ค.

์ง„๋‹จ

qSOFA, NEWS2, SIRS์˜ ํ•œ๊ตญ ์‘๊ธ‰์‹ค validation์ด ์ œ์‹œ๋œ๋‹ค. ์ Š์€ ํ™˜์ž์™€ ๊ณ ๋ น ํ™˜์ž์—์„œ sepsis marker ์„ฑ๋Šฅ์ด ๋‹ค๋ฅด๊ฒŒ ์ž‘๋™ํ•˜๋Š”์ง€ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋‹ค. ๋ฐœ์—ด ์—†์Œ ๋˜๋Š” lactate ์Œ์„ฑ ์ƒํƒœ์—์„œ๋„ occult infection ๊ฐ€๋Šฅ์„ฑ์„ ๊ณ ๋ คํ•œ๋‹ค.

์น˜๋ฃŒ

๋‹จ์ˆœํžˆ ํ•ญ์ƒ์ œ ํˆฌ์—ฌ ์‹œ๊ฐ„๋งŒ ๋ณด๋Š” ์—ฐ๊ตฌ๋Š” ์ด๋ฏธ ๋งŽ์•„, ํŠน์ • subgroup๊ณผ pathway ์—ฐ๊ตฌ๊ฐ€ ๋” ์ ํ•ฉํ•˜๋‹ค. SSC Hour-1 bundle์€ ์ถœ์ฒ˜๋กœ ์–ธ๊ธ‰๋˜๋‚˜ raw ์ž๋ฃŒ๋Š” ์„ธ๋ถ€ ์ฒ˜์น˜ ํ•ญ๋ชฉ์„ ๊ธฐ์ˆ ํ•˜์ง€ ์•Š๋Š”๋‹ค.

์ถœ์ฒ˜

Surviving Sepsis Campaign 2021; SSC Hour-1 bundle.

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.