Understanding, assessing and treating immune, endothelial and haemostasis dysfunctions in bacterial sepsis.

IF 27.1 1区 医学 Q1 CRITICAL CARE MEDICINE Intensive Care Medicine Pub Date : 2024-10-01 Epub Date: 2024-09-02 DOI:10.1007/s00134-024-07586-2
Massimo Girardis, Sascha David, Ricard Ferrer, Julie Helms, Nicole P Juffermans, Ignacio Martin-Loeches, Pedro Povoa, Lene Russell, Manu Shankar-Hari, Toshiaki Iba, Irene Coloretti, Nicholas Parchim, Nathan D Nielsen
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Abstract

The interplay between the immune system, coagulation, and endothelium is critical in regulating the host response to infection. However, in sepsis and other critical illnesses, a dysregulated immune response can lead to excessive alterations in these mechanisms, resulting in coagulopathy, endothelial dysfunction, and multi-organ dysfunction. This review aims to provide a comprehensive analysis of the pathophysiological mechanisms that govern the complex interplay between immune dysfunction, endothelial dysfunction, and coagulation in sepsis. It emphasises clinical significance, evaluation methods, and potential therapeutic interventions. Understanding these mechanisms is essential for developing effective treatments that can modulate the immune response, mitigate thrombosis, restore endothelial function, and ultimately improve patient survival.

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了解、评估和治疗细菌性败血症的免疫、内皮和止血功能障碍。
免疫系统、凝血和内皮之间的相互作用对于调节宿主对感染的反应至关重要。然而,在败血症和其他危重疾病中,失调的免疫反应可导致这些机制的过度改变,从而导致凝血功能障碍、内皮功能障碍和多器官功能障碍。本综述旨在全面分析败血症中免疫功能障碍、内皮功能障碍和凝血功能障碍之间复杂相互作用的病理生理机制。它强调了临床意义、评估方法和潜在的治疗干预措施。了解这些机制对于开发可调节免疫反应、缓解血栓形成、恢复内皮功能并最终提高患者生存率的有效治疗方法至关重要。
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来源期刊
Intensive Care Medicine
Intensive Care Medicine 医学-危重病医学
CiteScore
51.50
自引率
2.80%
发文量
326
审稿时长
1 months
期刊介绍: Intensive Care Medicine is the premier publication platform fostering the communication and exchange of cutting-edge research and ideas within the field of intensive care medicine on a comprehensive scale. Catering to professionals involved in intensive medical care, including intensivists, medical specialists, nurses, and other healthcare professionals, ICM stands as the official journal of The European Society of Intensive Care Medicine. ICM is dedicated to advancing the understanding and practice of intensive care medicine among professionals in Europe and beyond. The journal provides a robust platform for disseminating current research findings and innovative ideas in intensive care medicine. Content published in Intensive Care Medicine encompasses a wide range, including review articles, original research papers, letters, reviews, debates, and more.
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