• Massimo Girardis, Sascha David, Ricard Ferrer, Julie Helms, Nicole P Juffermans, Ignacio Martin-Loeches, Pedro Povoa, Lene Russell, Manu Shankar-Hari, Toshiaki Iba, Irene Coloretti, Nicholas Parchim, and Nathan D Nielsen.
• Anaesthesiology and Intensive Care Department, University Hospital of Modena, University of Modena, Reggio Emilia, Italy. girardis.massimo@unimore.it.
• Intensive Care Med. 2024 Oct 1; 50 (10): 158015921580-1592.

AbstractThe interplay between the immune system, coagulation, and endothelium is critical in regulating the host response to infection. However, in sepsis and other critical illnesses, a dysregulated immune response can lead to excessive alterations in these mechanisms, resulting in coagulopathy, endothelial dysfunction, and multi-organ dysfunction. This review aims to provide a comprehensive analysis of the pathophysiological mechanisms that govern the complex interplay between immune dysfunction, endothelial dysfunction, and coagulation in sepsis. It emphasises clinical significance, evaluation methods, and potential therapeutic interventions. Understanding these mechanisms is essential for developing effective treatments that can modulate the immune response, mitigate thrombosis, restore endothelial function, and ultimately improve patient survival.© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.

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