Perna Benedetta, Raparelli Valeria, Tordo Caprioli Federica, Blanaru Oana Teodora, Malacarne Cecilia, Crosetti Cecilia, Portoraro Andrea, Zanotto Alex, Strocchi Francesco Maria, Rapino Alessandro, Costanzini Anna, Maritati Martina, Lazzari Roberto, Spampinato Michele Domenico, Contini Carlo, De Giorgio Roberto, Guarino Matteo
Department of Translational Medicine, University Hospital of Ferrara, 44124 Ferrara, Italy.
Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy.
Microorganisms. 2024 Apr 18;12(4):821. doi: 10.3390/microorganisms12040821.
Sex and gender are fundamental health determinants and their role as modifiers of treatment response is increasingly recognized. Norepinephrine is a cornerstone of septic shock management and its use is based on the highest level of evidence compared to dopamine. The related 2021 Surviving Sepsis Campaign (SCC) recommendation is presumably applicable to both females and males; however, a sex- and gender-based analysis is lacking, thus not allowing generalizable conclusions. This paper was aimed at exploring whether sex- and gender-disaggregated data are available in the evidence supporting this recommendation. For all the studies underpinning it, four pairs of authors, including a woman and a man, extracted data concerning sex and gender, according to the Sex and Gender Equity in Research guidelines. Nine manuscripts were included with an overall population of 2126 patients, of which 43.2% were females. No sex analysis was performed and gender was never reported. In conclusion, the present manuscript highlighted that the clinical studies underlying the SCC recommendation of NE administration in septic shock have neglected the likely role of sex and gender as modifiers of treatment response, thus missing the opportunity of sex- and gender-specific guidelines.
性别是基本的健康决定因素，其作为治疗反应调节因素的作用日益受到认可。去甲肾上腺素是脓毒症休克治疗的基石，与多巴胺相比，其使用基于最高级别的证据。2021年脓毒症存活运动（SCC）的相关建议可能适用于男性和女性；然而，缺乏基于性别和性别的分析，因此无法得出可推广的结论。本文旨在探讨在支持该建议的证据中是否有按性别和性别的分类数据。对于所有支持该建议的研究，包括一名女性和一名男性在内的四对作者根据《研究中的性别与性公平指南》提取了有关性别和性别的数据。纳入了9篇手稿，总共有2126名患者，其中43.2%为女性。未进行性别分析，性别也从未被报告。总之，本手稿强调，脓毒症休克中SCC关于使用去甲肾上腺素的建议所依据的临床研究忽略了性别作为治疗反应调节因素的可能作用，从而错失了制定针对性别和性别的指南的机会。
