Journal of Critical Care Medicine最新文献

{"title":"The challenge of antimicrobial resistance in intensive care setting.","authors":"Prisco Piscitelli, Vincenzo Costigliola, Leonard Azamfirei","doi":"10.2478/jccm-2025-0020","DOIUrl":"10.2478/jccm-2025-0020","url":null,"abstract":"","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"109-111"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of antiseizure medication on mortality in spontaneous aneurysmal subarachnoid hemorrhage.","authors":"John Harold Kanter, Adam C Glaser, Pablo Martinez-Camblor, Jakob V E Gerstl, Anna B Lebouille-Veldman, Harshit Arora, Lauren Buhl, Myles D Boone, Christopher S Ogilvy","doi":"10.2478/jccm-2025-0014","DOIUrl":"10.2478/jccm-2025-0014","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of morbidity and mortality in the United States. The efficacy of early antiseizure medication (ASM) is debated. Recent literature reports seizure rates ranging from 7.8% to 15.2% following spontaneous aSAH. Current guidelines recommend use of early ASM in patients with \"high-risk features,\" but whether early ASM use decreases the rate of death associated with aSAH remains unclear. This study assessed whether early administration of early ASM impacts mortality rates after spontaneous aSAH.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using a publicly available dataset from the Massachusetts Institute of Technology, Medical Information Mart for Intensive Care-III (MIMIC) database of all patients over the age of 18 with spontaneous aSAH resulting in an intensive care unit (ICU) admission to a major United States trauma center from 2001 to 2012. The primary exposure was receiving early ASM and primary outcome of death within 7 days. Different regression models were created to explore the association between early ASM administration within 24 hours of admission and a composite outcome of seizure and/or death within 7 days of admission. Secondary outcomes included 30-day and one-year mortality.</p><p><strong>Results: </strong>Of 253 patients with spontaneous aSAH, 148 received early ASM within 24 hours. Patients who did receive early ASM were less likely to die within 7 days of admission (adjusted odd ratio, [aOR]: 0.26 95% CI 0.10 to 0.68; P=0.006) but were more likely to have a seizure (aOR: 7.63 95% CI 2.07 to 28.17; P=0.002).</p><p><strong>Conclusion: </strong>Early ASM administration was associated with lower rates of death and composite death/seizure within 7 days of admission among patients who presented to an ICU with spontaneous aSAH. These findings suggest broader use of early ASM in patients who present with spontaneous aSAH may improve early mortality.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"173-182"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of biomarkers testing in Emergency Department.","authors":"Sonia Luka, Adela Golea, Raluca Mihaela Tat, Eugenia Maria Lupan Mureșan, George Teo Voicescu, Ștefan Cristian Vesa, Maria Adriana Albu, Daniela Ionescu","doi":"10.2478/jccm-2024-0041","DOIUrl":"10.2478/jccm-2024-0041","url":null,"abstract":"<p><strong>Introduction: </strong>In the fast-paced environment of Emergency Departments (EDs), biomarkers are essential for the rapid diagnosis and management of critical conditions.</p><p><strong>Aim of the study: </strong>This study evaluates the current clinical practice on key biomarkers in Romanian EDs, addressing the needs of emergency medicine physicians, and the challenges associated with biomarker testing.</p><p><strong>Material and methods: </strong>An online survey was sent to physicians working in ED to explore their perceptions, needs, and barriers regarding biomarkers, including Point-of-care (POC). Data was collected anonymously through an online platform and subsequently analyzed.</p><p><strong>Results: </strong>This survey analyzed data from 168 completed responses, with 95.2% of respondents being specialists in emergency medicine. Procalcitonin and presepsin were most preferred for PoCT, while troponin and D-dimer were highly rated regardless of the testing method, reflecting their utility in sepsis and cardiovascular emergencies. Neuron-specific enolase, interleukin-6, and procalcitonin were the biomarkers considered needed.</p><p><strong>Conclusions: </strong>The most frequently used biomarkers in ED were troponin, D-dimer, BNP/NT-proBNP, and procalcitonin. NSE, IL-6, and procalcitonin were the most recommended for future integration. High costs, limited availability, and false-positive concerns remain significant challenges in biomarker use.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"164-172"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A brief report on the association of preoperative hematological indices and acute deep vein thrombosis following total hip arthroplasty for osteoarthritis.","authors":"Razvan Marian Melinte, Matei Florin Negrut, Daniel Oltean-Dan, Adrian Dumitru Ivanescu, Tudor-Mihai Magdas, Oana Antal, Adela Hilda Onutu, Marian Andrei Melinte, Robert Bolcas","doi":"10.2478/jccm-2025-0018","DOIUrl":"10.2478/jccm-2025-0018","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is a standard orthopedic procedure. Deep vein thrombosis (DVT) and pulmonary embolism are potential life-threatening postoperative complications.</p><p><strong>Aim of the study: </strong>This study aimed to assess the prognostic value of systemic inflammatory indices [monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)] and their potential association with acute postoperative DVT.</p><p><strong>Materials and methods: </strong>We designed a multicentric, retrospective, observational cohort study, including adult patients undergoing elective HTA. Patients were divided into two groups, the DVT and non-DVT groups. We investigated the development of acute DVT early, and at 4 weeks after surgery and also registered length of hospital stay and mortality. All demographic data and laboratory data, hematological indices were extracted from patients files.</p><p><strong>Results: </strong>199 patients were included. Of those, 12 (6.03%) developed DVT and 187 (93.97%) did not. There was no statistically significant difference between patient age, gender, BMI, smoking status or comorbidities. No difference was founds between the two groups regarding median values of MLR (0.31 vs 0.27, p=0.12), NLR (3.16 vs 2.42, p=0.27), PLR (163.39 vs 123.01, p=0.27), SII (660.26 vs 568.52, p=0.33), SIRI (67.5 vs 65.26, p=0.89) and AISI (302.35 vs 290.48, p=0.85). Length of hospital stay was not significantly different (median 9 days in the DVT group vs 7 days in the non-DVT group, p=0.38), but mortality was significantly higher in the DVT group (3 deaths vs none in the non-DVT group, p<0.001).</p><p><strong>Conclusion: </strong>MLR, NLR, PRL, SII, SIRI and AISI were not associated with the development of acute DVT following HTA in our study population.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"192-197"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and temporality of the ventilatory techniques in the management of acute respiratory distress syndrome: A scoping review.","authors":"Théo Battalian, Raúl Escudero Romero, Arianne Barzaga Molina","doi":"10.2478/jccm-2025-0019","DOIUrl":"10.2478/jccm-2025-0019","url":null,"abstract":"<p><strong>Introduction: </strong>Acute Respiratory Distress Syndrome (ARDS) is a critical condition characterised by acute respiratory failure due to increased alveolar-capillary membrane permeability. This leads to non-cardiogenic pulmonary oedema, hypoxemia, and impaired respiratory compliance, significantly impacting patients' survival and quality of life. The management of ARDS involves various ventilatory and non-ventilatory therapies. Understanding the optimal timing and application of these therapies is crucial for improving patient outcomes.</p><p><strong>Aim of the study: </strong>This scoping review aims to identify and synthesise the ventilatory techniques used in managing ARDS, focusing on their temporality and the interplay between different therapies. The study seeks to synthesize the available evidence and summarize current management strategies, highlighting areas for further research and improvement in ARDS care.</p><p><strong>Material and methods: </strong>A systematic search of PubMed, EBSCO, and ScienceDirect databases was conducted, following the Joanna Briggs Institute guidelines (2015), for articles published between 2013 and 2023. Studies involving adult patients (18 years or older) diagnosed with ARDS and receiving ventilatory support in the ICU were included. Exclusion criteria included other acute respiratory pathologies, clinically extreme obese patients, and patients with tracheostomy.</p><p><strong>Results: </strong>437 articles were identified through the database search, of which 23 met the inclusion criteria and were included in the final review. Most articles were published between 2015-2019 (43.5%), originated from the USA (34.78%), and employed observational study designs (73.91%). The included studies reported on patients aged between 23 and 79 years, with intrapulmonary causes being the most common aetiology for ARDS. Various ventilatory strategies were identified, including conventional oxygen therapy, high-flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive ventilation (IMV), and combined approaches. Temporality was reported in 35% of the articles, but none of them as their primary focus.</p><p><strong>Conclusions: </strong>The review highlights the diversity of ventilatory techniques employed in ARDS management and the importance of individualizing treatment strategies based on patient response and disease severity. The temporality of these interventions remains a crucial aspect, requiring further investigation to establish clearer guidelines for optimizing the timing and sequence of ventilatory support in ARDS. The findings underscore the need for future research to focus on patient-centred outcomes and the long-term implications of ARDS management, including quality of life and functional status.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"122-131"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of prone position in spontaneous breathing in patients with COVID-19.","authors":"Rodrigo Cerqueira Borges, Isadora Salvador Rocco, Camila Botana Alves Ferreira, Mauricio Kenzo Tobara, Cristiane Helena Papacidero, Vanessa Chaves Barreto Ferreira, Andrey Wirgues Sousa","doi":"10.2478/jccm-2025-0015","DOIUrl":"10.2478/jccm-2025-0015","url":null,"abstract":"<p><strong>Objective: </strong>To investigate if awake prone position (PP) reduces the rate of endotracheal intubation and mortality in patients with COVID-19 admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This was a retrospective cohort study of 726 patients who were admitted to the ICU with acute hypoxic respiratory failure secondary to COVID-19. The protocol of the institution recommended the use of awake PP in patients with nasal catheter with an oxygen flow ≥ 5 L/min and SpO₂ ≤ 90% or a high-flow nasal catheter (HFNC) with FiO₂ ≥ 50% and SpO₂ ≤ 90%. The following data were collected: age, comorbidities, SAPS-3 score, onset of symptoms, the degree of pulmonary involvement, duration of invasive and noninvasive MV, HFNC therapy, nitric oxide therapy, hemodialysis and PP while spontaneously breathing.</p><p><strong>Results: </strong>There was a higher mortality rate in the supine position group (27.1%) than in the awake PP group (13.9%). There was no significant difference in the time on MV or number of patients on MV (p>0.05). The variables with p < 0.05 in the bivariate analysis were entered into the Cox regression model. The model was adjusted for awake PP, sex, age, SAPS-3 score, onset of symptoms, the degree of pulmonary involvement, chronic arterial disease, and noninvasive ventilation. The only variable associated with lower mortality over time was awake PP (hazard ratio: 0.55; 95% confidence interval: 0.33-0.92).</p><p><strong>Conclusion: </strong>Awake prone position has been shown to be a safe and effective therapy that reduced mortality but not the risk of intubation in patients with COVID-19.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"149-156"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management strategies and outcomes predictors of interstitial lung disease exacerbation admitted to an intensive care setting: A narrative review.","authors":"Ans Alamami","doi":"10.2478/jccm-2025-0013","DOIUrl":"10.2478/jccm-2025-0013","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung disease (ILD) is a cluster of diseases that affect the lungs, characterized by different degrees of inflammation and fibrosis within the parenchyma. In the intensive care unit (ICU), ILD poses substantial challenges because of its complicated nature and high morbidity and mortality rates in severe cases. ILD pathophysiology frequently entails persistent inflammation that results in fibrosis, disrupting the typical structure and function of the lung. Patients with ILD frequently experience dyspnea, non-productive cough, and tiredness. In the ICU setting, these symptoms may worsen and lead to signs of acute respiratory failure with significantly impaired gas physiology.</p><p><strong>Methodology: </strong>A systematic search was conducted in reputable databases, including PubMed, Google Scholar, and Embase. To ensure a comprehensive search, a combination of keywords such as \"interstitial lung disease,\" \"intensive care,\" and \"outcomes\" was used. Studies published within the last ten years reporting on the outcomes of ILD patients admitted to intensive care included.</p><p><strong>Result: </strong>Effective management of ILD in an ICU setting is challenging and requires a comprehensive approach to address the triggering factor and providing respiratory support, Hypoxemia severity is a critical predictor of mortality, with lower PaO₂/FiO₂ ratios during the first three days of ICU admission associated with increased mortality rates. The need for mechanical ventilation, particularly invasive mechanical ventilation (IMV), is a significant predictor of poor outcomes in ILD patients. Additionally, higher positive end-expiratory pressure (PEEP) settings, and severity of illness scores, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score, are also linked to increased mortality. Other poor prognostic factors include the presence of shock and pulmonary fibrosis on computed tomography (CT) images. Among the various types of ILDs, idiopathic pulmonary fibrosis (IPF) is associated with the highest mortality rate. Furthermore, a high ventilatory ratio (VR) within 24 hours after intubation independently predicts ICU mortality.</p><p><strong>Conclusion: </strong>This literature review points out outcome predictors of interstitial lung disease in intensive care units, which are mainly hypoxemia, the severity of the illness, invasive ventilation, the presence of shock, and the extent of fibrosis on CT Images.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"112-121"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of intraventricular vancomycin in subacute brain abscess in an adolescent male: A case report.","authors":"Tomas Leng, Ibrahim Serhat Karakus","doi":"10.2478/jccm-2024-0046","DOIUrl":"10.2478/jccm-2024-0046","url":null,"abstract":"<p><strong>Introduction: </strong>Brain abscess is a serious condition in children, leading to rapid deterioration, and permanent neurological damage associated with significant morbidity and mortality. Current management protocols for brain abscesses focus on intravenous antibiotics and surgical excision and drainage.</p><p><strong>Case presentation: </strong>A 12-year-old adolescent male who had headache and photophobia and was diagnosed with multiple brain abscesses and was refractory to conventional medical and neurosurgical intervention. A single dose of 10 mg vancomycin was administered through endo-ventricular drain, resulting in resolution of abscesses and alleviation of symptoms.</p><p><strong>Conclusion: </strong>We describe the first instance of intraventricular vancomycin use in the pediatric age group for the treatment of multiple brain abscesses. Given the variability in dosing reported in the literature, our case report warrants further studies to standardize dosage for this rare intervention.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"192-195"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ability to identify patient-ventilator asynchronies in intensive care unit professionals: A multicenter cross-sectional analytical study.","authors":"Andrés Mauricio Enríquez Popayán, Iván Ignacio Ramírez, Juan Felipe Zúñiga, Ruvistay Gutierrez-Arias, Mayda Alejandra Jiménez Pérez, Henry Mauricio Parada-Gereda, Luis Fernando Pardo Cocuy, Ana Lucia Rangel Colmenares, Nubia Castro Chaparro, Ana Pinza Ortega, Jorge Martínez Díaz, Johanna Hurtado Laverde, Joismer Alejandro Henao Cruz","doi":"10.2478/jccm-2025-0017","DOIUrl":"10.2478/jccm-2025-0017","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-ventilator asynchrony (PVA) is frequent in intensive care. Its presence is associated with prolonged days of mechanical ventilation and may lead to increased mortality in the intensive care unit (ICU) and hospital. Little is known about the ability of Colombian intensive care professionals to identify asynchronies, and the factors associated with their correct identification are not apparent.</p><p><strong>Aim of the study: </strong>To describe the ability of Colombian intensive care professionals to identify patient-ventilator asynchronies (PVA) using waveform analysis. In addition, to define the characteristics associated with correctly detecting PVA.</p><p><strong>Material and methods: </strong>We conducted a multicenter, cross-sectional, national survey-based study between January and August 2024. Colombian physiotherapists, respiratory therapists, nurses and intensive care physicians from 24 departments participated in the study. An online survey was used. They were asked to identify six different PVAs presented as videos. The videos were displayed using pressure/time and flow/time waveform of a Puritan Bennett 840 ventilator.</p><p><strong>Results: </strong>We recruited 900 participants, 60% female, most of whom were physiotherapists (53%). Most professionals had specialty training in critical care (42%), and 32% reported having specific PVA training. Double triggering was the most frequently identified PVA (75%). However, only 3.67% of participants recognized all six PVAs. According to multiple logistic regression analysis, working in a mixed unit (OR 2.59; 95% CI 1.19 - 5.54), caring for neonates (OR 5.19; 95% CI 1.77 - 15.20), and having specific training (OR 2.38; 95% CI 1.16 - 4.76) increases the chance of correctly recognizing all PVAs.</p><p><strong>Conclusion: </strong>In Colombia, a low percentage of professionals recognize all PVAs. Having specific training in this topic, working in mixed ICUs and neonatal intensive care was significantly associated with identifying all PVAs.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"157-163"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into sepsis-induced apoptosis: Interplay between programmed cell death and interleukin-7.","authors":"Anca Meda Văsiesiu, Oana Coman, Raluca Stefania Fodor, Anca Bacârea, Bianca-Liana Grigorescu","doi":"10.2478/jccm-2025-0003","DOIUrl":"10.2478/jccm-2025-0003","url":null,"abstract":"<p><p>The pathophysiology of sepsis is orchestrated by a delicate and dynamic interaction between pro-inflammatory and anti-inflammatory responses. Essential factors influencing this process include interleukin-7 (IL-7), the programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) axis, and cellular apoptosis. These elements shape the immune response in sepsis, influencing its progression and outcomes. IL-7 is an important cytokine maintaining lymphocyte function and survival. At the same time, the PD-1/PD-L1 axis acts as a modulatory checkpoint suppressing immune activation to prevent overreaction but can exacerbate immunosuppression during sepsis. Cellular apoptosis impairs the host's ability to mount an effective defence, especially against secondary infections. Despite extensive research, the precise mechanisms through which sepsis results in organ dysfunction and immune dysregulation remain incompletely understood. The global burden of sepsis emphasizes the urgent need for innovative approaches, paving the way for personalized, immune-based therapies. This review aims to delve into and synthesize the current knowledge regarding cellular apoptosis, the regulatory role of the PD-1/PD-L1 axis, and the critical functions of IL-7 in sepsis, with a focus on their underlying mechanisms, clinical relevance, and potential as targets for future immunomodulatory treatments.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"132-139"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}