Advances in the combined management of bacteria,toxins,and inflammatory mediators for the prevention and treatment of traumatic sepsis
10.3969/j.issn.1008-9691.2024.05.019
- VernacularTitle:"菌毒炎并治"防治创伤性脓毒症的研究进展
- Author:
Kaijin XIE
1
;
Jing YU
;
Yu XIA
;
Guochang LIU
;
Daiqi CHEN
;
Lu KANG
;
Yaoli WANG
;
Jun YAN
Author Information
1. 陆军军医大学(第三军医大学)大坪医院 野战外科研究部特殊环境战伤防治研究室,创伤与化学中毒全国重点实验室,重庆 400042;陆军军医大学(第三军医大学)大坪医院 重症医学科,重庆 400042
- Publication Type:Journal Article
- Keywords:
Bacteria;
Toxin;
Inflammatory mediator;
Traumatic sepsis
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(5):625-629
- CountryChina
- Language:Chinese
-
Abstract:
Traumatic sepsis is a life-threatening organ dysfunction syndrome caused by an uncontrolled host response to infection after trauma. It is characterized by complex pathogenesis,and rapid deterioration of clinical condition,and is often accompanied by septic shock and multiple organ dysfunction. The incidence and mortality of traumatic sepsis are high,and its treatment presents more difficult. The occurrence of traumatic sepsis is not only related to the traumatic type and severity,but also influenced by various factors such as the type of pathogenic microorganisms,the timing of infection,and the intensity of the immune response. As the key character in the progression of severe traumatic infection,the excessive inflammatory response and immune imbalance are important causes to constitute risk factors and biomarkers of traumatic sepsis. Previous studies on the prevention and treatment of traumatic sepsis paid more attention to early infection control,effective anti-infection treatment,fluid resuscitation,immune modulation and supportive treatment,especially for antibiotics use. However,the role of inflammatory response was ignored in the prognosis of traumatic patients. The immune system activation after trauma not only plays a crucial role in preventing and controlling infections but also closely relates to the systemic inflammatory response. Excessive or uncontrolled inflammatory response may exacerbate the situation of patients with traumatic sepsis,trigger multiple organ dysfunction syndrome (MODS),and even result in death. Current studies imply that the combined treatment of bacteria,their toxins,and inflammatory mediators may be a key measure for preventing and treating traumatic sepsis. This strategy emphasizes not only anti-infection therapy against pathogenic microorganisms but also immune modulation to suppress excessive inflammatory response and restore immune balance. The pattern of "combined treatment of bacteria,their toxins,and inflammation" is expected to reduce the incidence and mortality of traumatic sepsis by inhibiting excessive inflammatory response and enhancing immune capacity. This review describes the progress of the combined treatment of bacteria,their toxins,and inflammatory mediators in preventing and treatment for traumatic sepsis,from the perspectives of epidemiology,risk factors,biomarkers,pathogenesis,concept development,and application. It provides a new idea to study and research the key technologies for the prevention and treatment of severe traumatic complications.
