Nicola Henrique
Intensive Care Registrar Trainee, Royal Perth Hospital, 197 Wellington St Perth, Western Australia, 6000 Australia.
J Intensive Care. 2017 May 30;5:31. doi: 10.1186/s40560-017-0228-x. eCollection 2017.
Septic shock remains challenging to intensive care units worldwide, despite recent documented improvement in mortality over the years. Multiple new therapies have been attempted without success in large clinical trials. Evidence concerning the role of the contact system and bradykinin on septic shock physiological manifestations is shown by this article.
The objective of the study is to review the current evidence linking contact system activation and septic shock, as well as efficacy of available therapies targeting this pathophysiological pathway and to evaluate the potential of further researching the matter.
Multiple animal studies are already available and suggestive of a meaningful role of contact system activation on septic shock. However, human trials are still scarce, and the ones available are not enough to establish such a strong connection. Furthermore, attempted therapies have been successful across multiple species, but not as much in humans. Therefore, contact system and septic shock relationship remains plentiful in questions to be answered in the coming years or decades.
Whether the contact system is not as relevant in humans as it is in animals or there is only lack of evidence remains to be explained. The subject is an attractive open field for further research aiming to aid in tackling such a burdensome condition.
尽管近年来有文献记载脓毒症休克的死亡率有所改善，但它仍然是全球重症监护病房面临的挑战。多种新疗法在大型临床试验中尝试但未成功。本文展示了关于接触系统和缓激肽在脓毒症休克生理表现中作用的证据。
本研究的目的是回顾当前将接触系统激活与脓毒症休克联系起来的证据，以及针对这一病理生理途径的现有疗法的疗效，并评估进一步研究该问题的潜力。
已有多项动物研究表明接触系统激活在脓毒症休克中具有重要作用。然而，人体试验仍然很少，现有的人体试验不足以建立如此紧密的联系。此外，尝试的疗法在多个物种中取得了成功，但在人体中效果不佳。因此，接触系统与脓毒症休克的关系在未来几年或几十年仍有许多问题有待解答。
接触系统在人类中是否不如在动物中相关，或者只是缺乏证据，仍有待解释。该主题是一个有吸引力的开放研究领域，旨在帮助应对这种棘手的病症。
