Alvaro Maria Eugenia, Caserta Santino, Stagno Fabio, Fazio Manlio, Gangemi Sebastiano, Genovese Sara, Allegra Alessandro
Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, Via Consolare Valeria, 98125 Messina, Italy.
Allergy and Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy.
Curr Oncol. 2025 Aug 10;32(8):450. doi: 10.3390/curroncol32080450.
Septic shock is a life-threatening complication of sepsis, particularly in patients with hematologic diseases who are highly susceptible to it due to profound immune dysregulation. Recent advances in artificial intelligence offer promising tools for improving septic shock diagnosis, prognosis, and treatment in this vulnerable population. In detail, these innovative models analyzing electronic health records, immune function, and real-time physiological data have demonstrated superior performance compared to traditional scoring systems such as Sequential Organ Failure Assessment. In patients with hematologic malignancies, machine learning approaches have shown strong accuracy in predicting the sepsis risk using biomarkers like lactate and red cell distribution width, the latter emerging as a powerful, cost-effective predictor of mortality. Deep reinforcement learning has enabled the dynamic modelling of immune responses, facilitating the design of personalized treatment regimens helpful in reducing simulated mortality. Additionally, algorithms driven by artificial intelligence can optimize fluid and vasopressor management, corticosteroid use, and infection risk. However, challenges related to data quality, transparency, and ethical concerns must be addressed to ensure their safe integration into clinical practice. Clinically, AI could enable earlier detection of septic shock, better patient triage, and tailored therapies, potentially lowering mortality and the number of ICU admissions. However, risks like misclassification and bias demand rigorous validation and oversight. A multidisciplinary approach is crucial to ensure that AI tools are implemented responsibly, with patient-centered outcomes and safety as primary goals. Overall, artificial intelligence holds transformative potential in managing septic shock among hematologic patients by enabling timely, individualized interventions, reducing overtreatment, and improving survival in this high-risk group of patients.
感染性休克是脓毒症的一种危及生命的并发症,尤其在血液系统疾病患者中,由于严重的免疫失调,他们对此高度易感。人工智能的最新进展为改善这一脆弱人群的感染性休克诊断、预后和治疗提供了有前景的工具。具体而言,这些分析电子健康记录、免疫功能和实时生理数据的创新模型,与传统评分系统如序贯器官衰竭评估相比,已显示出卓越的性能。在血液系统恶性肿瘤患者中,机器学习方法在使用乳酸和红细胞分布宽度等生物标志物预测脓毒症风险方面表现出很高的准确性,后者已成为一种强大且具有成本效益的死亡率预测指标。深度强化学习能够对免疫反应进行动态建模,有助于设计个性化治疗方案,从而降低模拟死亡率。此外,由人工智能驱动的算法可以优化液体和血管活性药物管理、皮质类固醇使用以及感染风险。然而,必须解决与数据质量、透明度和伦理问题相关的挑战,以确保它们安全地融入临床实践。在临床上,人工智能能够实现感染性休克的早期检测、更好的患者分诊和量身定制的治疗,有可能降低死亡率和重症监护病房(ICU)收治人数。然而,诸如错误分类和偏差等风险需要严格的验证和监督。多学科方法对于确保人工智能工具以患者为中心的结果和安全为主要目标、负责任地实施至关重要。总体而言,人工智能通过实现及时、个性化的干预,减少过度治疗,并提高这一高危患者群体的生存率,在管理血液系统疾病患者的感染性休克方面具有变革潜力。