Trzeciak Alissa, Pietropaoli Anthony P, Kim Minsoo
Department of Microbiology and Immunology, David H. Smith Center for Vaccine Biology and Immunology, University of Rochester Medical Center, Rochester, NY, USA.
Pulmonary and Critical Care Medicine Division, University of Rochester, Rochester, NY, USA.
Immune Netw. 2020 Jun 22;20(3):e23. doi: 10.4110/in.2020.20.e23. eCollection 2020 Jun.
Sepsis is conceptually defined as life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Although there has been significant advancement in recent decades in defining and understanding sepsis pathology, clinical management of sepsis is challenging due to difficulties in diagnosis, a lack of reliable prognostic biomarkers, and treatment options that are largely limited to antibiotic therapy and fundamental supportive measures. The lack of reliable diagnostic and prognostic tests makes it difficult to triage patients who are in need of more urgent care. Furthermore, while the acute inpatient treatment of sepsis warrants ongoing attention and investigation, efforts must also be directed toward longer term survival and outcomes. Sepsis survivors experience incomplete recovery, with long-term health impairments that may require both cognitive and physical treatment and rehabilitation. This review summarizes recent advances in sepsis prognosis research and discusses progress made in elucidating the underlying causes of prolonged health deficits experienced by patients surviving the early phases of sepsis.
脓毒症在概念上被定义为由宿主对感染的失调反应引起的危及生命的器官功能障碍。尽管近几十年来在脓毒症病理学的定义和理解方面取得了重大进展，但由于诊断困难、缺乏可靠的预后生物标志物以及治疗选择主要限于抗生素治疗和基本支持措施，脓毒症的临床管理具有挑战性。缺乏可靠的诊断和预后测试使得难以对需要更紧急护理的患者进行分诊。此外，虽然脓毒症的急性住院治疗值得持续关注和研究，但也必须致力于改善长期生存和预后。脓毒症幸存者恢复不完全，存在长期健康损害，可能需要认知和身体治疗及康复。本综述总结了脓毒症预后研究的最新进展，并讨论了在阐明脓毒症早期存活患者长期健康缺陷的潜在原因方面所取得的进展。
