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Sepsis-3-Definition − Ein Fortschritt?

Sepsis-3 definition—a step forward?

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Zusammenfassung

Die Mehrzahl der seit Februar 2016 publizierten Validierungsstudien bestätigen die Ergebnisse der Sepsis-3 Task Force und belegen, dass der qSOFA-Score (Quick Sequential Organ Failure Assessment Score) ein geeigneter Parameter ist, um Patienten mit Infektionsverdacht auf das Vorliegen einer Sepsis zu screenen. Die SIRS-Kriterien (SIRS: systemisches inflammatorisches Response-Syndrom) sind weiterhin sinnvoll in der Diagnose der zugrunde liegenden Infektion. Verglichen mit einem qSOFA-Score von 0 Punkten oder 1 Punkt haben Patienten mit einem qSOFA-Score von 2 und 3 Punkten ein 3 bis 14-fach erhöhtes Risiko zu versterben. Die Sepsis-3 Task Force hat jedoch empfohlen, die Behandlung nicht zu verzögern, bis die Patienten 2 oder mehr qSOFA-Kriterien erfüllen. Weitere prospektive Studien müssen zeigen, ob eine längsschnittliche und wiederholte Anwendung des qSOFA im intraindividuellen Verlauf sinnvoll ist. Darüber hinaus wäre eine prospektive kontrollierte Studie, die den klinischen Nutzen des qSOFA im Vergleich zu einer Standardbehandlung hinsichtlich harter Outcome-Parameter untersucht, von Bedeutung.

Abstract

The majority of the validation studies published since February 2016 confirm the results of the Sepsis-3 Task Force and show that the Quick Sepsis-related Organ Failure Assessment (qSOFA) score is a suitable parameter for screening patients with a suspected infection for the presence of sepsis. SIRS criteria may still remain useful for the identification of infection. Compared to a qSOFA score of 0 or 1 point, patients with a qSOFA score of 2 and 3 points have a 3- to 14-fold increased risk of dying. However, the Sepsis-3 Task Force has recommended that treatment should not be delayed until patients meet 2 or more qSOFA criteria. Neither qSOFA nor SOFA is intended to be a stand-alone definition of sepsis. Further prospective studies must show whether a longitudinal and repeated application of the qSOFA in the intraindividual course makes sense. In addition, a prospective controlled trial that examined the clinical benefit of qSOFA compared to standard treatment for hard outcome parameters would be important.

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Authors and Affiliations

  1. Integriertes Forschungs- und Behandlungszentrum (IFB) Zentrum für Sepsis und Sepsisfolgen (CSCC), Jena, Deutschland

    F. M. Brunkhorst

  2. Klinik für Anaesthesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland

    F. M. Brunkhorst

  3. Zentrum für Klinische Studien, Universitätsklinikum Jena, Jena, Deutschland

    F. M. Brunkhorst

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  1. F. M. Brunkhorst
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Correspondence to F. M. Brunkhorst.

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F. M. Brunkhorst gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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M. Christ, Luzern

F. Brunkhorst, Jena

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Brunkhorst, F.M. Sepsis-3-Definition − Ein Fortschritt?. Notfall Rettungsmed 22, 184–188 (2019). https://doi.org/10.1007/s10049-018-0467-y

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  • DOI: https://doi.org/10.1007/s10049-018-0467-y

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