在重症监护室发生危及生命的免疫相关不良事件:叙述性综述
Samuel Pichon1, Ghadi Zebian2,3, Côme Bureau4
1Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes et Auto-Inflammatoires Systémiques Rares de l'Adulte du Nord, Univ. Lille, CHU Lille, Nord-Ouest, Méditerranée et Guadeloupe (CeRAINOM), Inserm, INFINITE U1286, Lille, France. samuel.pichon0@gmail.com.
癌症免疫疗法的严重免疫相关不良事件 (irAEs) 需要密集护理. 早期识别和多学科管理,包括量身定制的免疫抑制,可以改善这些关键毒性的生存率.
科学领域:
- 在瘤学瘤学.
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 改善癌症存活率,但会导致与免疫相关的不良事件 (irAEs).
- 严重的irrAEs可能危及生命,需要重症监护室 (ICU) 管理.
- 这些毒性影响多个器官系统,通常在ICI治疗的早期表现出来.
研究的目的:
- 审查需要ICU护理的严重IRAE的流行病学,诊断和管理.
- 为突出免疫抑制策略超越皮质类固醇.
- 强调血液动力学支持和多学科协调.
主要方法:
- 在2025年8月之前对相关文献进行叙述性审查.
- 专注于在ICU中管理严重的IRE的证据.
- 综合目前关于诊断和治疗的数据.
主要成果:
- 早期识别,结构化诊断和多学科护理对于更好的结果至关重要.
- 及时诊断和个性化免疫抑制可以改善存活率,尽管心肌炎等病例的死亡率高.
- 在某些已康复的患者中,可以考虑重新使用ICI.
结论:
- 密集型医生必须准备好管理IREs,因为ICI的使用正在扩大.
- 有效的管理包括在ICU中平衡免疫调节与瘤目标.
- 为了优化患者的治疗结果,多学科的合作是必不可少的.
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