Sepsis Review: Antibiotics, Fluids, Vasopressors and SBP | Part 2 | 敗血症 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字；遇到過度簡化或舊門檻，請搭配下方提示與原始資料閱讀。這是概念學習材料，不替代個別醫療評估。

Lyrics · 完整歌詞

All patients with suspected sepsis have lactate measured
and cultures drawn before antibiotics,
which must start within one hour.
Is the mean arterial pressure still below 65 mmHg after 30 mL/kg of crystalloid?
Then noradrenaline is the first-line vasopressor.
On Sepsis-3 criteria,
septic shock means vasopressor dependence plus a lactate above 2 mmol/L,
not a count of inflammatory signs.
Lumen to peritoneum, enteric Gram-negative bacilli cause spontaneous bacterial peritonitis,
diagnosed at 250 neutrophils and treated with cefotaxime.

All patients with suspected sepsis have lactate measured
and cultures drawn before antibiotics,
which must start within one hour.
Is the mean arterial pressure still below 65 mmHg after 30 mL/kg of crystalloid?
Then noradrenaline is the first-line vasopressor.
On Sepsis-3 criteria,
septic shock means vasopressor dependence plus a lactate above 2 mmol/L,
not a count of inflammatory signs.
Lumen to peritoneum, enteric Gram-negative bacilli cause spontaneous bacterial peritonitis,
diagnosed at 250 neutrophils and treated with cefotaxime.

Medical Notes · 醫學學習提示

  1. 疑似敗血症測乳酸，合併評估灌流與器官功能
  2. 盡可能先採培養；不可因此延誤抗菌治療
  3. 休克或高度疑似敗血症：立即用藥，理想一小時內
  4. 低灌流／休克：前三小時約30 mL/kg，動態評估
  5. 去甲腎上腺素為休克第一線升壓劑
  6. 感染引起失調宿主反應，造成器官功能障礙
  7. 充分補液後，需升壓維持MAP≥65且乳酸>2 mmol/L
  8. 敗血性休克並非只靠發炎指標的數量診斷
  9. 肝硬化腹水可能感染；院內菌種與抗藥性不同
  10. 腹水PMN≥250/µL；排除次發感染，依抗藥性選藥
  11. 無休克且僅可能敗血症：快速評估，仍疑感染三小時內用藥
  12. Cefotaxime適用部分社區型病例；仍須依當地抗藥性

References