Zhang Pengju, Zou Bingwen, Liou Yih-Cherng, Huang Canhua
State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, No.17 People's South Road, Chengdu, 610041, China.
Department of Thoracic Oncology and Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu, 610041, China.
Burns Trauma. 2021 Feb 4;9:tkaa047. doi: 10.1093/burnst/tkaa047. eCollection 2021 Jan.
Burn is an under-appreciated trauma that is associated with unacceptably high morbidity and mortality. Although the survival rate after devastating burn injuries has continued to increase in previous decades due to medical advances in burn wound care, nutritional and fluid resuscitation and improved infection control practices, there are still large numbers of patients at a high risk of death. One of the most common complications of burn is sepsis, which is defined as "severe organ dysfunction attributed to host's disordered response to infection" and is the primary cause of death in burn patients. Indeed, burn injuries are accompanied by a series of events that lead to sepsis and multiple organ dysfunction syndrome, such as a hypovolaemic state, immune and inflammatory responses and metabolic changes. Therefore, clear diagnostic criteria and predictive biomarkers are especially important in the prevention and treatment of sepsis and septic shock. In this review, we focus on the pathogenesis of burn wound infection and the post-burn events leading to sepsis. Moreover, the clinical and promising biomarkers of burn sepsis will also be summarized.
烧伤是一种未得到充分重视的创伤，其发病率和死亡率高得令人难以接受。尽管在过去几十年中，由于烧伤创面护理、营养和液体复苏以及感染控制措施的改进等医学进展，严重烧伤后的生存率持续上升，但仍有大量患者面临高死亡风险。烧伤最常见的并发症之一是脓毒症，其定义为“由于宿主对感染的紊乱反应导致的严重器官功能障碍”，是烧伤患者死亡的主要原因。事实上，烧伤会伴随一系列导致脓毒症和多器官功能障碍综合征的事件，如低血容量状态、免疫和炎症反应以及代谢变化。因此，明确的诊断标准和预测性生物标志物在脓毒症和感染性休克的预防和治疗中尤为重要。在本综述中，我们重点关注烧伤创面感染的发病机制以及导致脓毒症的烧伤后事件。此外，还将总结烧伤脓毒症的临床和有前景的生物标志物。
