Berg Daniela, Gerlach Herwig
Department of Anesthesia, Critical Care Medicine, and Pain Management, Vivantes - Klinikum Neukoelln, Berlin, Berlin, Germany.
F1000Res. 2018 Sep 28;7. doi: 10.12688/f1000research.15758.1. eCollection 2018.
The last two to three years provided several "big steps" regarding our understanding and management of sepsis. The increasing insight into pathomechanisms of post-infectious defense led to some new models of host response. Besides hyper-, hypo-, and anti-inflammation as the traditional approaches to sepsis pathophysiology, tolerance and resilience were described as natural ways that organisms react to microbes. In parallel, huge data analyses confirmed these research insights with a new way to define sepsis and septic shock (called "Sepsis-3"), which led to discussions within the scientific community. In addition to these advances in understanding and defining the disease, follow-up protocols of the initial "sepsis bundles" from the Surviving Sepsis Campaign were created; some of them were part of quality management studies by clinicians, and some were in the form of mandatory procedures. As a result, new "bundles" were initiated with the goal of enabling standardized management of sepsis and septic shock, especially in the very early phase. This short commentary provides a brief overview of these two major fields as recent hallmarks of sepsis research.
在过去两到三年里，我们对脓毒症的理解和管理取得了几个“重大进展”。对感染后防御病理机制的深入了解催生了一些新的宿主反应模型。除了作为脓毒症病理生理学传统研究方法的炎症亢进、炎症减退和抗炎反应外，耐受性和恢复力被描述为生物体对微生物作出反应的自然方式。与此同时，大规模数据分析以一种定义脓毒症和脓毒性休克的新方法（称为“脓毒症-3”）证实了这些研究成果，这引发了科学界的讨论。除了在理解和定义该疾病方面取得这些进展外，还制定了来自拯救脓毒症运动的初始“脓毒症集束治疗”的后续方案；其中一些是临床医生质量管理研究的一部分，还有一些是强制性程序的形式。因此，新的“集束治疗”被启动，目标是实现脓毒症和脓毒性休克的标准化管理，尤其是在极早期阶段。本简短评论简要概述了这两个主要领域，作为脓毒症研究的近期标志。
