Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Monneret, Guillaume; Venet, Fabienne; Pachot, Alexandre; Lepape, Alain

doi:10.2119/2007-00102.monneret

Cited by 298 publications

(345 citation statements)

References 192 publications

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“…Despite a large number of studies focusing on the measurement of plasma concentrations of various mediators, none of them has been consensually accepted [11]. In this context, we here demonstrated that serum cytokine levels did not provide a clear pro or anti-inflammatory pattern between severe sepsis and septic shock or between survival and nonsurvival patients.…”

Section: Discussioncontrasting

confidence: 68%

“…There are several methods to study CARS in the septic patient, including functional testing, measurement of circulating mediators and cellular and apoptosis monitoring [11]. Using functional testing and cellular monitoring several advances in the understanding of CARS were made in the last few years.…”

Section: Discussionmentioning

confidence: 99%

“…These dysfunctions could be used as potential markers on a routine standardized basis for prediction of adverse outcome from sepsis or to obtain further insights to the pathophysiology of sepsisinduced immunosuppression. [11]. Thus, this study aims to determine the relation between in vitro macrophage activation and the severity and clinical outcome in septic patients as a tool to study CARS in the septic patient.…”

Section: Introductionmentioning

confidence: 99%

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Serum-induced macrophage activation is related to the severity of septic shock

et al. 2009

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum-induced macrophage activation is related to the severity of septic shock

et al. 2009

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“…HLA-DR molecules are upregulated in response to inflammation [83] . Monocytes with low HLA-DR expression are unable to generate a proinflammatory response to microbial challenge or properly present antigens to T cells [84,85] . Decreased mHLA-DR levels could predict poor outcome and septic Kojic D et al .…”

Section: Human Leukocyte Antigen-dr On Circulating Monocytesmentioning

confidence: 99%

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Kojic

Siegler

Uhle

et al. 2015

WJEM

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Beside many efforts to improve outcome, sepsis is still one of the most frequent causes of death in critically ill patients. It is the most common condition with high mortality in intensive care units. The complexity of the septic syndrome comprises immunological aspects -i.e. , sepsis induced immunosuppression -but is not restricted to this fact in modern concepts. So far, exact mechanisms and variables determining outcome and mortality stay unclear. Since there is no typical risk profile, early diagnosis and risk stratification remain difficult, which hinders rapid and effective treatment initiation. Due to the heterogeneous nature of sepsis, potential therapy options should be adapted to the individual. Biomarkers like C-reactive protein and procalcitonin are routinely used as complementary tools in clinical decision-making. Beyond the acute phase proteins, a wide bunch of promising substances and non-laboratory tools with potential diagnostic and prognostic value is under intensive investigation. So far, clinical decision just based on biomarker assessment is not yet feasible. However, biomarkers should be considered as a complementary approach. Core tip: Sepsis is a complex continuum of disturbed systems. Despite the presence of clinical consensus criteria, the early diagnosis especially in the perioperative setting is challenging. A magnitude of potential new biomarkers is tested for this purpose, but evidence is mounting that due to the complex nature of the syndrome, biomarkers are rather complementary tools for clinical decision making than "magic bullets". Moreover, biomarkers are also evaluated for therapy guidance, linking diagnostic results to an individual therapeutic regime. This review summarizes the developments in the biomarker field, aiming to provide an overview about current targets and their limitations.

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“…They found that PCT decreased from day 2 to day 3 in both, the appropriate and inappropriate groups, but the decrease was significantly greater in the appropriate group. This can be explained by the finding that adequate supportive therapy on its own may attenuate the inflammatory response [80]. Furthermore, monocytes become exhausted after a certain period of time, also affecting PCT production [81,82].…”

Section: Appropriate Antimicrobial Therapymentioning

confidence: 99%

Early procalcitonin kinetics and adequate empiric antibiotic therapy in critically ill

Trásy¹

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Monitoring Immune Dysfunctions in the Septic Patient: A New Skin for the Old Ceremony

Cited by 298 publications

References 192 publications

Serum-induced macrophage activation is related to the severity of septic shock

Serum-induced macrophage activation is related to the severity of septic shock

Are there new approaches for diagnosis, therapy guidance and outcome prediction of sepsis?

Early procalcitonin kinetics and adequate empiric antibiotic therapy in critically ill

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