Challenges with Diagnosing and Managing Sepsis in Older Adults

被引：81

作者：

Clifford, Kalin M. ^{[1
]}

Dy-Boarman, Eliza A. ^{[2
]}

Haase, Krystal K. ^{[3
]}

Maxvill, Kristen ^{[1
]}

Pass, Steven E. ^{[1
]}

Alvarez, Carlos A. ^{[1
,4
]}

机构：

[1] Texas Tech Univ, Hlth Sci Ctr, Dept Pharm Practice, Dallas, TX USA

[2] Drake Univ, Dept Clin Sci, Des Moines, IA 50311 USA

[3] Texas Tech Univ, Hlth Sci Ctr, Dept Pharm Practice, Amarillo, TX USA

[4] Univ Texas Southwestern, Dept Clin Sci, Dallas, TX USA

来源：

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY | 2016年 / 14卷 / 02期

基金：

美国国家卫生研究院;

关键词：

Sepsis; elderly; antibiotic therapy; immunosenescence; inflammation; vasopressor therapy; ONSET ATRIAL-FIBRILLATION; SEPTIC SHOCK; FLUID RESUSCITATION; ELDERLY-PATIENTS; NOREPINEPHRINE; DOPAMINE; CARE; MORTALITY; INFECTION; BACTEREMIA;

D O I：

10.1586/14787210.2016.1135052

中图分类号：

R51 [传染病];

学科分类号：

100201 [内科学];

摘要：

Sepsis in older adults has many challenges that affect rate of septic diagnosis, treatment, and monitoring parameters. Numerous age-related changes and comorbidities contribute to increased risk of infections in older adults, but also atypical symptomatology that delays diagnosis. Due to various pharmacokinetic/pharmacodynamic changes in the older adult, medications are absorbed, metabolized, and eliminated at different rates as compared to younger adults, which increases risk of adverse drug reactions due to use of drug therapy needed for sepsis management. This review provides information to aid in diagnosis and offers recommendations for monitoring and treating sepsis in the older adult population.

引用

页码：231 / 241

页数：11

共 66 条

[1]

Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock:: a randomised trial [J].

Annane, Djillali ;

Vignon, Philippe ;

Renault, Alain ;

Bollaert, Pierre-Edouard ;

Charpentier, Claire ;

Martin, Claude ;

Troche, Gilles ;

Ricard, Jean-Damien ;

Nitenberg, Gerard ;

Papazian, Laurent ;

Azoulay, Elie ;

Bellissant, Eric .

LANCET, 2007, 370 (9588) :676-684

[2]

High versus Low Blood-Pressure Target in Patients with Septic Shock [J].

Asfar, Pierre ;

Meziani, Ferhat ;

Hamel, Jean-Francois ;

Grelon, Fabien ;

Megarbane, Bruno ;

Anguel, Nadia ;

Mira, Jean-Paul ;

Dequin, Pierre-Francois ;

Gergaud, Soizic ;

Weiss, Nicolas ;

Legay, Francois ;

Le Tulzo, Yves ;

Conrad, Marie ;

Robert, Rene ;

Gonzalez, Frederic ;

Guitton, Christophe ;

Tamion, Fabienne ;

Tonnelier, Jean-Marie ;

Guezennec, Pierre ;

Van der Linden, Thierry ;

Vieillard-Baron, Antoine ;

Mariotte, Eric ;

Pradel, Gael ;

Lesieur, Olivier ;

Ricard, Jean-Damien ;

Herve, Fabien ;

du Cheyron, Damien ;

Guerin, Claude ;

Mercat, Alain ;

Teboul, Jean-Louis ;

Radermacher, Peter .

NEW ENGLAND JOURNAL OF MEDICINE, 2014, 370 (17) :1583-1593

[3]

Immunosenescence: emerging challenges for an ageing population [J].

Aw, Danielle ;

Silva, Alberto B. ;

Palmer, Donald B. .

IMMUNOLOGY, 2007, 120 (04) :435-446

[4]

Baeuchamp TL, 2013, PRINCIPLES BIOMEDICA

[5]

Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit [J].

Barr, Juliana ;

Fraser, Gilles L. ;

Puntillo, Kathleen ;

Ely, E. Wesley ;

Gelinas, Celine ;

Dasta, Joseph F. ;

Davidson, Judy E. ;

Devlin, John W. ;

Kress, John P. ;

Davidson, Judy E. ;

Devlin, John W. ;

Kress, John P. ;

Joffe, Aaron M. ;

Coursin, Douglas B. ;

Herr, Daniel L. ;

Tung, Avery ;

Robinson, Bryce R. H. ;

Fontaine, Dorrie K. ;

Ramsay, Michael A. ;

Riker, Richard R. ;

Sessler, Curtis N. ;

Pun, Brenda ;

Skrobik, Yoanna ;

Jaeschke, Roman .

CRITICAL CARE MEDICINE, 2013, 41 (01) :263-306

[6]

Pitfalls in the Diagnosis and Therapy of Infections in Elderly Patients - A Mini-Review [J].

Bellmann-Weiler, Rosa ;

Weiss, Guenter .

GERONTOLOGY, 2009, 55 (03) :241-249

[7]

Bellomo R, 2000, LANCET, V356, P2139

[8]

Clinical relevance of age-related immune dysfunction [J].

Castle, SC .

CLINICAL INFECTIOUS DISEASES, 2000, 31 (02) :578-585

[9]

Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine [J].

Cecconi, Maurizio ;

De Backer, Daniel ;

Antonelli, Massimo ;

Beale, Richard ;

Bakker, Jan ;

Hofer, Christoph ;

Jaeschke, Roman ;

Mebazaa, Alexandre ;

Pinsky, Michael R. ;

Teboul, Jean Louis ;

Vincent, Jean Louis ;

Rhodes, Andrew .

INTENSIVE CARE MEDICINE, 2014, 40 (12) :1795-1815

[10]

Neutrophil dysfunction and infection risk in end-stage renal disease [J].

Chonchol, Michel .

SEMINARS IN DIALYSIS, 2006, 19 (04) :291-296

← 1 2 3 4 5 6 7 →