Understanding, assessing and treating immune, endothelial and haemostasis dysfunctions in bacterial sepsis

Massimo Girardis, Sascha David, Ricard Ferrer, Julie Helms, Nicole P Juffermans, Ignacio Martin-Loeches, Pedro Povoa, Lene Russell, Manu Shankar-Hari, Toshiaki Iba, Irene Coloretti, Nicholas Parchim, Nathan D Nielsen

Abstract

The interplay between the immune system, coagulation, and endothelium is critical in regulating the host response to infection. However, in sepsis and other critical illnesses, a dysregulated immune response can lead to excessive alterations in these mechanisms, resulting in coagulopathy, endothelial dysfunction, and multi-organ dysfunction. This review aims to provide a comprehensive analysis of the pathophysiological mechanisms that govern the complex interplay between immune dysfunction, endothelial dysfunction, and coagulation in sepsis. It emphasises clinical significance, evaluation methods, and potential therapeutic interventions. Understanding these mechanisms is essential for developing effective treatments that can modulate the immune response, mitigate thrombosis, restore endothelial function, and ultimately improve patient survival.

OriginalsprogEngelsk
TidsskriftIntensive Care Medicine
Vol/bind50
Udgave nummer10
Sider (fra-til)1580-1592
Antal sider13
ISSN0342-4642
DOI
StatusUdgivet - okt. 2024

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