Therapeutic Approaches in Modulating the Inflammatory and Immunological Response in Patients With Sepsis, Acute Respiratory Distress Syndrome, and Pancreatitis: An Expert Opinion Review

被引：10

作者：

Mehta, Yatin ^{[1
]}

Dixit, Subhal B. ^{[2
]}

Zirpe, Kapil ^{[3
]}

Sud, Randhir ^{[4
]}

Gopal, Palepu B. ^{[5
]}

Koul, Parvaiz A. ^{[6
]}

Mishra, Vijay K. ^{[7
]}

Ansari, Abdul S. ^{[8
]}

Chamle, Vijay S. ^{[9
]}

机构：

[1] Medanta Medic, Inst Crit Care & Anesthesiol, Gurugram, India

[2] Sanjeevan Hosp, Crit Care Med, Pune, Maharashtra, India

[3] Grant Med Fdn, Ruby Hall Clin, Neurocrit Care, Pune, Maharashtra, India

[4] Medanta Medic, Inst Digest & Hepatobiliary Sci, Gurugram, India

[5] Continental Hosp, Dept Crit Care, Hyderabad, India

[6] Sherikashmir Inst Med Sci, Dept Pulm Med, Srinagar, India

[7] Bhagwan Mahavir Med Superspecial Hosp, Medica Inst Crit Care, Ranchi, Bihar, India

[8] Nanavati Super Special Hosp, Dept Crit Care Serv, Mumbai, Maharashtra, India

[9] Urihk Pharmaceut, Med Affairs, Mumbai, Maharashtra, India

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2021年 / 13卷 / 09期

关键词：

immunomodulators; sepsis; ards; covid-19; steroid; ulinastatin; CORTICOSTEROID-THERAPY; SEPTIC SHOCK; IMMUNOMODULATORY THERAPY; TRYPSIN-INHIBITOR; THYMOSIN ALPHA1; CYTOKINE STORM; VITAMIN-C; ULINASTATIN; METAANALYSIS; IMMUNOGLOBULIN;

D O I：

10.7759/cureus.18393

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Immune dysfunction is common in critically ill patients who are more vulnerable to infections and the systemic consequences of dysfunctional defense responses. Immune dysfunction directly affects patient morbidity and mortality [1-3]. Critically ill patients respond differently to the injury. The response may be characterized by either pronounced inflammatory reaction or injury-related immunosuppression [2,4]. The exaggerated immune response is primarily due to the release of proinflammatory cytokines, often referred to as cytokine storm, which is common in critically ill patients with infections or injuries (e.g., sepsis, acute respiratory distress syndrome [ARDS]) [5]. Even in patients with acute pancreatitis (AP), the early systemic inflammatory response is associated with severe disease, and systemic inflammation and organ failure depict the same mechanisms observed in sepsis and ARDS [6,7]. The progression of dysregulated immune response along with infection, inflammation, ischemia, and/or shock leads to multiorgan dysfunction

引用

页数：14