{"id":33276,"date":"2024-03-13T02:26:58","date_gmt":"2024-03-12T18:26:58","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&p=33276"},"modified":"2025-02-11T13:39:42","modified_gmt":"2025-02-11T05:39:42","slug":"dong-thuan-quoc-te-tieu-chi-nhiem-khuan-huyet-va-soc-nhiem-khuan-o-tre-em","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/dong-thuan-quoc-te-tieu-chi-nhiem-khuan-huyet-va-soc-nhiem-khuan-o-tre-em\/","title":{"rendered":"\u0110\u1ed3ng thu\u1eadn qu\u1ed1c t\u1ebf: Ti\u00eau ch\u00ed nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb em"},"content":{"rendered":"\n

Nhi\u1ec5m khu\u1ea9n huy\u1ebft l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u d\u1eabn \u0111\u1ebfn t\u1eed vong \u1edf tr\u1ebb em tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Ti\u00eau ch\u00ed cho nhi\u1ec5m khu\u1ea9n huy\u1ebft \u1edf tr\u1ebb em hi\u1ec7n nay \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 n\u0103m 2005 \u0111\u1ec1u d\u1ef1a tr\u00ean \u00fd ki\u1ebfn chuy\u00ean gia. V\u00e0o n\u0103m 2016, \u0110\u1ecbnh ngh\u0129a \u0110\u1ed3ng thu\u1eadn Qu\u1ed1c t\u1ebf v\u1ec1 Nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 S\u1ed1c nhi\u1ec5m khu\u1ea9n l\u1ea7n th\u1ee9 3(Sepsis \u2013 3) \u0111\u1ecbnh ngh\u0129a nhi\u1ec5m khu\u1ea9n l\u00e0 t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u1edf c\u01a1 quan g\u00e2y nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng do r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a \u0111\u00e1p \u1ee9ng nhi\u1ec5m tr\u00f9ng c\u1ee7a c\u01a1 th\u1ec3. Tuy nhi\u00ean ti\u00eau ch\u00ed n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i cho tr\u1ebb em.<\/p>\n\n\n\n

V\u00e0o n\u0103m 2024, m\u1ed9t \u0111\u1ed3ng thu\u1eadn qu\u1ed1c t\u1ebf \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra \u0111\u1ec3 c\u1eadp nh\u1eadt v\u00e0 ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb em.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Ti\u00eau ch\u00ed x\u00e1c \u0111\u1ecbnh nhi\u1ec5m khu\u1ea9n huy\u1ebft \u1edf tr\u1ebb em<\/strong><\/p>\n\n\n\n

Nhi\u1ec5m khu\u1ea9n huy\u1ebft \u1edf tr\u1ebb em \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh th\u00f4ng qua ti\u00eau ch\u00ed nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix (Phoenix sepsis criteria). Ti\u00eau ch\u00ed n\u00e0y \u0111i\u1ec3m qua nh\u1eefng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p, tim m\u1ea1ch, \u0111\u00f4ng m\u00e1u v\u00e0\/ho\u1eb7c h\u1ec7 th\u1ea7n kinh c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m t\u00ednh m\u1ea1ng \u1edf tr\u1ebb em b\u1ecb nghi ng\u1edd ho\u1eb7c \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh nhi\u1ec5m khu\u1ea9n (b\u1ea3ng 1). Tr\u1ebb em b\u1ecb nghi ng\u1edd nhi\u1ec5m khu\u1ea9n c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong t\u1ea1i vi\u1ec7n 0.7 \u2013 3.6% trong v\u00f2ng 24 gi\u1edd \u0111\u1ea7u k\u1ec3 t\u1eeb khi nh\u1eadp vi\u1ec7n. Thang \u0111i\u1ec3m Nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix \u2265 2 c\u00f3 gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n d\u01b0\u01a1ng t\u00ednh cao h\u01a1n v\u00e0 \u0111\u1ed9 nh\u1ea1y cao h\u01a1n ho\u1eb7c t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi \u0111\u1ecbnh ngh\u0129a nhi\u1ec5m khu\u1ea9n huy\u1ebft c\u1ee7a IPSCC trong d\u1ef1 \u0111o\u00e1n t\u1ef7 l\u1ec7 t\u1eed vong t\u1ea1i vi\u1ec7n trong v\u00f2ng 24 gi\u1edd k\u1ec3 t\u1eeb khi \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n.<\/p>\n\n\n\n

B\u1ea3ng 1.<\/strong> Thang \u0111i\u1ec3m nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Ti\u00eau ch\u00ed x\u00e1c \u0111\u1ecbnh s\u1ed1c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng \u1edf tr\u1ebb em<\/strong><\/p>\n\n\n\n

S\u1ed1c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh \u1edf tr\u1ebb em b\u1ecb nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u1edbi t\u1ed1i thi\u1ec3u 1 \u0111i\u1ec3m tim m\u1ea1ch (\u0111\u00e1nh gi\u00e1 theo thang \u0111i\u1ec3m Phoenix, c\u1ee5 th\u1ec3 h\u1ea1 huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng so v\u1edbi tu\u1ed5i, lactate m\u00e1u > 5 mmol\/L ho\u1eb7c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi thu\u1ed1c v\u1eadn m\u1ea1ch) (h\u00ecnh 1). T\u1ef7 l\u1ec7 l\u01b0u h\u00e0nh c\u1ee7a s\u1ed1c nhi\u1ec5m khu\u1ea9n \u1edf tr\u1ebb em b\u1ecb nhi\u1ec5m khu\u1ea9n huy\u1ebft l\u00e0 53.7 \u2013 81.3%, t\u1ef7 l\u1ec7 t\u1eed vong do s\u1ed1c nhi\u1ec5m khu\u1ea9n t\u01b0\u01a1ng \u1ee9ng l\u00e0 10.8 \u2013 33.5%.<\/p>\n\n\n\n


H\u00ecnh 1.<\/strong> Quy tr\u00ecnh ch\u1ea9n \u0111o\u00e1n s\u1eed d\u1ee5ng ti\u00eau ch\u00ed nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng m\u1edbi \u1edf tr\u1ebb em<\/p>\n\n\n\n

R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan xa t\u1eeb \u1ed5 nhi\u1ec5m<\/strong><\/p>\n\n\n\n

B\u1ec7nh nhi \u0111\u00e1p \u1ee9ng ti\u00eau ch\u00ed nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix, bao g\u1ed3m r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan gi\u1edbi h\u1ea1n \u1edf c\u01a1 quan nhi\u1ec5m khu\u1ea9n v\u00e0 b\u1ec7nh nhi c\u00f3 \u0111i\u1ec3m nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix g\u1ee3i \u00fd r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan xa do \u1ed5 nhi\u1ec5m. Tr\u1ebb em b\u1ecb nhi\u1ec5m khu\u1ea9n huy\u1ebft k\u00e8m r\u1ed1i lo\u1ea1n c\u01a1 quan xa t\u1eeb \u1ed5 nhi\u1ec5m, bao g\u1ed3m b\u1ec7nh nh\u00e2n s\u1ed1c nhi\u1ec5m khu\u1ea9n v\u00e0 b\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u0111a c\u01a1 quan xa t\u1eeb \u1ed5 nhi\u1ec5m l\u00e0 nh\u00f3m b\u1ec7nh nh\u00e2n nhi\u1ec5m khu\u1ea9n huy\u1ebft quan tr\u1ecdng c\u1ea7n l\u01b0u \u00fd. B\u1ec7nh nh\u00e2n nhi\u1ec5m khu\u1ea9n huy\u1ebft k\u00e8m r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan xa t\u1eeb \u1ed5 nhi\u1ec5m c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong cao h\u01a1n (8.0 \u2013 32.3%). Ng\u01b0\u1ee3c l\u1ea1i, tr\u1ebb em c\u00f3 \u0111i\u1ec3m nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix \u2265 2 b\u1ecb r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan gi\u1edbi h\u1ea1n \u1edf v\u1ecb tr\u00ed \u1ed5 nhi\u1ec5m ti\u00ean ph\u00e1t c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong 1.7 \u2013 6.1%.<\/p>\n\n\n\n

K\u1ebft lu\u1eadn<\/strong><\/p>\n\n\n\n

Ti\u00eau ch\u00ed nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix cho nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng \u1edf tr\u1ebb em \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng v\u00e0 th\u1ea9m \u0111\u1ecbnh b\u1edfi SCCM Pediatric Sepsis Definition Task Force qu\u1ed1c t\u1ebf, b\u1eb1ng c\u01a1 s\u1edf d\u1eef li\u1ec7u \u0111\u1ed3 s\u1ed9, t\u1ed5ng quan h\u1ec7 th\u1ed1ng, ph\u00e2n t\u00edch g\u1ed9p v\u00e0 \u0111\u1ed3ng thu\u1eadn Delphi hi\u1ec7u ch\u1ec9nh. \u0110i\u1ec3m nhi\u1ec5m khu\u1ea9n huy\u1ebft Phoenix \u2265 2 h\u1ed7 tr\u1ee3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01a1 quan c\u00f3 th\u1ec3 nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng \u1edf tr\u1ebb em < 18 tu\u1ed5i b\u1ecb nhi\u1ec5m khu\u1ea9n huy\u1ebft. Thang \u0111i\u1ec3m nay c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 c\u1ea3i thi\u00ean t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng, \u0111\u00e1nh gi\u00e1 d\u1ecbch t\u1ec5 v\u00e0 nghi\u00ean c\u1ee9u trong l\u0129nh v\u1ef1c nhi\u1ec5m khu\u1ea9n huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m khu\u1ea9n h\u1ec7 th\u1ed1ng \u1edf tr\u1ebb em.<\/p>\n\n\n\n

\n\n\n\n

Ngu\u1ed3n<\/strong><\/p>\n\n\n\n

Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Jan 21. doi: 10.1001\/jama.2024.0179.<\/p>\n","protected":false},"excerpt":{"rendered":"

Nhi\u1ec5m khu\u1ea9n huy\u1ebft l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u d\u1eabn \u0111\u1ebfn t\u1eed vong \u1edf tr\u1ebb em tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Ti\u00eau ch\u00ed cho nhi\u1ec5m khu\u1ea9n huy\u1ebft \u1edf tr\u1ebb em hi\u1ec7n nay \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 n\u0103m 2005 \u0111\u1ec1u d\u1ef1a tr\u00ean \u00fd ki\u1ebfn chuy\u00ean gia. <\/p>\n","protected":false},"author":123,"featured_media":33337,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1440],"articles_languages":[1375],"articles_filters":[],"class_list":["post-33276","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/33276","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=33276"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/33276\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/33337"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=33276"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=33276"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=33276"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=33276"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=33276"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=33276"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}