Min Seung Yeon, Yong Ho Jin, Kim Dohhyung
Department of Internal Medicine, Dankook University Hospital, Cheonan, Korea.
Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
Acute Crit Care. 2024 May;39(2):207-213. doi: 10.4266/acc.2024.00591. Epub 2024 May 24.
Gender disparities in intensive care unit (ICU) treatment approaches and outcomes are evident. However, clinicians often pay little attention to the importance of biological sex and sociocultural gender in their treatment courses. Previous studies have reported that differences between sexes or genders can significantly affect the manifestation of diseases, diagnosis, clinicians' treatment decisions, scope of treatment, and treatment outcomes in the intensive care field. In addition, numerous reports have suggested that immunomodulatory effects of sex hormones and differences in gene expression from X chromosomes between genders might play a significant role in treatment outcomes of various diseases. However, results from clinical studies are conflicting. Recently, the need for customized treatment based on physical, physiological, and genetic differences between females and males and sociocultural characteristics of society have been increasingly emphasized. However, interest in and research into this field are remarkably lacking in Asian countries, including South Korea. Through this review, we hope to enhance our awareness of the importance of sex and gender in intensive care treatment and research by briefly summarizing several principal issues, mainly focusing on sex and sex hormone-based outcomes in patients admitted to the ICU with sepsis and septic shock.
重症监护病房(ICU)治疗方法和结果中的性别差异很明显。然而,临床医生在其治疗过程中往往很少关注生物性别和社会文化性别因素的重要性。以往研究报告称,在重症监护领域,性别差异可显著影响疾病表现、诊断、临床医生的治疗决策、治疗范围及治疗结果。此外,众多报告表明,性激素的免疫调节作用以及两性X染色体基因表达差异可能在各种疾病的治疗结果中发挥重要作用。然而,临床研究结果相互矛盾。近来,基于男女之间身体、生理和基因差异以及社会的社会文化特征进行个性化治疗的需求日益受到重视。然而,包括韩国在内的亚洲国家对该领域的关注和研究明显不足。通过本综述,我们希望通过简要总结几个主要问题,提高对重症监护治疗和研究中性别因素重要性的认识,主要关注因脓毒症和脓毒性休克入住ICU患者基于性别和性激素的治疗结果。