Dipartimento di Scienze dell' Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Facoltà di Medicina e Chirurgia "A. Gemelli", Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Medicina (Kaunas). 2021 May 31;57(6):552. doi: 10.3390/medicina57060552.
Sepsis is triggered by infection-induced immune alteration and may be theoretically improved by pharmacological and extracorporeal immune modulating therapies. Pharmacological immune modulation may have long lasting clinical effects, that may even worsen patient-related outcomes. On the other hand, extracorporeal immune modulation allows short-term removal of inflammatory mediators from the bloodstream. Although such therapies have been widely used in clinical practice, the role of immune modulation in critically ill septic patients remains unclear and little evidence supports the role of immune modulation in this clinical context. Accordingly, further research should be carried out by an evidence-based and personalized approach in order to improve the management of critically ill septic patients.
脓毒症是由感染引起的免疫改变引发的,理论上可以通过药理学和体外免疫调节治疗来改善。药理学免疫调节可能具有持久的临床效果,甚至可能使与患者相关的结局恶化。另一方面,体外免疫调节可以从血液中短期去除炎症介质。尽管这些治疗方法已在临床实践中广泛应用,但免疫调节在危重症脓毒症患者中的作用仍不清楚,几乎没有证据支持免疫调节在这种临床情况下的作用。因此,应通过循证和个体化的方法进行进一步研究,以改善危重症脓毒症患者的治疗管理。