期刊
ANNALS OF INTENSIVE CARE
卷 11, 期 1, 页码 -出版社
SPRINGER
DOI: 10.1186/s13613-021-00893-7
关键词
Energetic dysfunction; Metabolism; Mitochondria; Mitochondrial dysfunction; Organ dysfunction; Sepsis; Septic shock; Infection
资金
- French Intensive Care Society (Societe de Reanimation de Langue Francaise)
- Deutsche Forschungsgemeinschaft [SFB 1149, GRK 2203]
Organ dysfunction in sepsis is associated with impaired metabolism and mitochondrial dysfunction, which could lead to new diagnostic and therapeutic approaches. These findings may help identify distinct subgroups of sepsis and develop personalized treatment strategies, while also serving as bioenergetic targets for metabolism- and mitochondria-targeted treatments in the future.
Background Growing evidence associates organ dysfunction(s) with impaired metabolism in sepsis. Recent research has increased our understanding of the role of substrate utilization and mitochondrial dysfunction in the pathophysiology of sepsis-related organ dysfunction. The purpose of this review is to present this evidence as a coherent whole and to highlight future research directions. Main text Sepsis is characterized by systemic and organ-specific changes in metabolism. Alterations of oxygen consumption, increased levels of circulating substrates, impaired glucose and lipid oxidation, and mitochondrial dysfunction are all associated with organ dysfunction and poor outcomes in both animal models and patients. The pathophysiological relevance of bioenergetics and metabolism in the specific examples of sepsis-related immunodeficiency, cerebral dysfunction, cardiomyopathy, acute kidney injury and diaphragmatic failure is also described. Conclusions Recent understandings in substrate utilization and mitochondrial dysfunction may pave the way for new diagnostic and therapeutic approaches. These findings could help physicians to identify distinct subgroups of sepsis and to develop personalized treatment strategies. Implications for their use as bioenergetic targets to identify metabolism- and mitochondria-targeted treatments need to be evaluated in future studies.
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