Abstract：
We reviewed the different studies using the terms \"refractory septic shock\" and/or \"catecholamine resistance\" and/or \"high dose norepinephrine\" so as to highlight the heterogeneity of the definitions used by authors addressing such concepts.
A systematic review was conducted assessing the papers reporting data on refractory septic shock. We used keywords as exact phrases and subject headings according to database syntax.
Of 276 papers initially reviewed, we included 8 studies - 3 randomized controlled trials, 3 prospective studies and 2 retrospective studies, representing a total of 562 patients with septic shock. Catecholamine resistance was generally defined as \"a decreased vascular responsiveness to catecholamine independently of the administered norepinephrine dose\". Refractory septic shock was broadly defined as \"a clinical condition characterized by persistent hyperdynamic shock even though adequate fluid resuscitation (individualized doses) and high doses of norepinephrine (≥ 1 μg/kg/min)\". Reported \"high doses\" of norepinephrine were often ≥1 μg/kg/min. However, wide variability was found throughout the literature on the use of these terms.
Marked inconsistencies were identified in the usage of the terms for refractory septic shock. There is a pressing need to determine consensus definitions so as to establish a common language in the medical literature and to harmonize future studies.
A systematic review was conducted assessing the papers reporting data on refractory septic shock. We used keywords as exact phrases and subject headings according to database syntax.
Of 276 papers initially reviewed, we included 8 studies - 3 randomized controlled trials, 3 prospective studies and 2 retrospective studies, representing a total of 562 patients with septic shock. Catecholamine resistance was generally defined as \"a decreased vascular responsiveness to catecholamine independently of the administered norepinephrine dose\". Refractory septic shock was broadly defined as \"a clinical condition characterized by persistent hyperdynamic shock even though adequate fluid resuscitation (individualized doses) and high doses of norepinephrine (≥ 1 μg/kg/min)\". Reported \"high doses\" of norepinephrine were often ≥1 μg/kg/min. However, wide variability was found throughout the literature on the use of these terms.
Marked inconsistencies were identified in the usage of the terms for refractory septic shock. There is a pressing need to determine consensus definitions so as to establish a common language in the medical literature and to harmonize future studies.
摘要：
背景：我们回顾了使用术语“难治性脓毒性休克”和/或“儿茶酚胺抵抗”和/或“高剂量去甲肾上腺素”的不同研究，以强调作者针对这些概念使用的定义的异质性。
方法：对报告难治性脓毒性休克数据的论文进行了系统评价。根据数据库语法，我们使用关键字作为确切的短语和主题标题。
结果：在最初审查的276篇论文中，我们纳入了8项研究-3项随机对照试验，3项前瞻性研究和2项回顾性研究，代表总共562例感染性休克患者。儿茶酚胺抵抗通常定义为“血管对儿茶酚胺的反应性降低，与去甲肾上腺素剂量无关”。难治性脓毒性休克被广泛定义为“即使进行了足够的液体复苏（个体化剂量）和高剂量的去甲肾上腺素（≥1μg/kg/min），但仍以持续的高动力休克为特征的临床状况”。报告的“高剂量”去甲肾上腺素通常≥1μg/kg/min。然而,在使用这些术语的文献中发现了广泛的可变性。
结论：在难治性脓毒性休克术语的使用中发现了明显的不一致。迫切需要确定共识定义，以便在医学文献中建立通用语言并协调未来的研究。
方法：对报告难治性脓毒性休克数据的论文进行了系统评价。根据数据库语法，我们使用关键字作为确切的短语和主题标题。
结果：在最初审查的276篇论文中，我们纳入了8项研究-3项随机对照试验，3项前瞻性研究和2项回顾性研究，代表总共562例感染性休克患者。儿茶酚胺抵抗通常定义为“血管对儿茶酚胺的反应性降低，与去甲肾上腺素剂量无关”。难治性脓毒性休克被广泛定义为“即使进行了足够的液体复苏（个体化剂量）和高剂量的去甲肾上腺素（≥1μg/kg/min），但仍以持续的高动力休克为特征的临床状况”。报告的“高剂量”去甲肾上腺素通常≥1μg/kg/min。然而,在使用这些术语的文献中发现了广泛的可变性。
结论：在难治性脓毒性休克术语的使用中发现了明显的不一致。迫切需要确定共识定义，以便在医学文献中建立通用语言并协调未来的研究。
