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Published on: March 29, 2017
Inflammatory Stewardship-A Perspective for Active Management of Acute Inflammation
Lennart Finn Herrlich1,2, Hubert Schrezenmeier1,2, David Alexander Christian Messerer1,2
1Institute of Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany.
Summary
Inflammatory stewardship offers a precision-medicine approach to manage acute inflammation after surgery and trauma. This strategy uses inflammatory staging and biomarker-guided immunomodulation for personalized patient care.
Area of Science:
- Critical care medicine
- Precision medicine
- Immunology
Background:
- Major surgery and trauma trigger systemic inflammation, which can become dysregulated.
- Dysregulated inflammation leads to complications, organ dysfunction, and mortality.
- Current management is limited by patient heterogeneity and lack of timely, precise monitoring.
Purpose of the Study:
- Introduce inflammatory stewardship as a precision-medicine paradigm.
- Outline a framework for proactive management of acute inflammation.
- Guide patient-specific immunomodulatory care in perioperative and critical settings.
Main Methods:
- Integrate inflammatory staging with biomarker-guided immunomodulation.
- Utilize serial, multidimensional monitoring for inflammatory trajectories.
- Combine clinical parameters with immune phenotyping and molecular signatures.
Main Results:
- Proposes a system for individualized inflammatory status assessment.
- Links aberrant inflammatory trajectories to tailored treatment adjustments.
- Emphasizes standardized, clinically interpretable assays with rapid turnaround times.
Conclusions:
- Inflammatory stewardship provides a roadmap for personalized inflammation management.
- Enables earlier detection of maladaptive inflammatory responses.
- Aims for more effective, patient-tailored immunomodulatory care in intensive care settings.
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