协和医学杂志2026，Vol.17Issue(1)：40-58,19.DOI:10.12290/xhyxzz.2025-1152
脓毒性休克血流氧流分型与临床管理专家共识(2025)
Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock(2025)
摘要
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infec-tion.Septic shock is the primary cause of mortality in sepsis,with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response.Due to the systemically convergent yet clinically heterogeneous nature of the host response,current understanding and management strategies for hemodynamics remain inconsistent,often leading to inadequate resuscitation or over-treatment.To improve the quality of care,based on a systematic review of the"blood flow-oxygen flow"theory,an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow,and has formulated the Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock(2025).The consensus proposes that clinical typing of blood flow-oxygen flow should comprehensively consider cardiac function,vascular tone,oxygen flow utilization status in critical units,and disease trajectory,while optimizing subtype identification by integrating host response phenotypes and artifi-cial intelligence technologies.It advocates establishing a continuous assessment system through multi-site oxygen flow monitoring for organ perfusion,peripheral perfusion monitoring,and critical care ultrasound.Under the framework of the"critical care triangle",the consensus promotes the implementation of individualized,bundled management strategies,providing guidance for multiple management points to restore blood flow-oxygen flow matching,reduce the risk of organ failure,and decrease patient mortality.关键词
脓毒性休克/血流-氧流/血流动力学/感染Key words
septic shock/blood flow-oxygen flow/hemodynamics/infection分类
医药卫生引用本文复制引用
黄薇,李冬凯,尹万红,王小亭,杜微,王欣晨,柴文昭,崔克亮,姚波,邢志群,王翠,刘晶晶,巩师毅..脓毒性休克血流氧流分型与临床管理专家共识(2025)[J].协和医学杂志,2026,17(1):40-58,19.基金项目
国家重点研发计划-常见多发病防治研究重点专项(2022YFC2504503) （2022YFC2504503）
中央高水平医院临床科研专项(2022-PUMCH-A-266) （2022-PUMCH-A-266）
国家科技重大专项(2024ZD0526100) National Key R&D Program of China(2022YFC2504503) （2024ZD0526100）
National High Level Hospital Clinical Research Funding(2022-PUMCH-A-266) （2022-PUMCH-A-266）
Noncommunicable Chronic Disease-National Science and Technology Major Projet(2024ZD0526100) （2024ZD0526100）
