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New Insights in the Diagnosis, Treatment and Monitoring of Anemia, Inflammation and Infection

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Prof. Dr. Christian Hönemann

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Guest Editor

1. Department of Anaesthesia, St. Marienhospital Vechta, Marienstraße 6-8, 49377 Vechta, Germany
2. Department of Anesthesiology and Critical Care, University Hospital of Muenster, Münster, Germany
Interests: anemia; anesthesia; patient blood management; intensive care; mechanical ventilation; resuscitation

Special Issue Information

Dear Colleagues,

Anemia, inflammation, and infection represent interconnected clinical challenges that significantly impact patient outcomes across various medical fields. Recent advancements in diagnostic tools, therapeutic strategies, and monitoring technologies have opened new avenues for addressing these conditions more effectively. However, a comprehensive and integrative approach is crucial to bridge the gaps in current practice and improve patient care.

This Special Issue calls for collaborative efforts to explore and implement innovative approaches in the diagnosis, treatment, and monitoring of anemia, inflammation, and infection. Emerging diagnostic modalities, including next-generation biomarkers and advanced imaging techniques, offer unprecedented accuracy and early detection capabilities. Therapeutic innovations, such as targeted biological agents and gene therapies, hold promise in addressing the underlying mechanisms of these conditions rather than merely alleviating symptoms. Furthermore, advancements in digital health technologies, including wearable devices and AI-driven analytics, provide real-time insights into patient status, enabling personalized and dynamic treatment adjustments.

Interdisciplinary research and clinical trials are essential to validate these innovations and assess their impact on long-term outcomes. Additionally, addressing disparities in access to these advancements is vital to ensure equitable healthcare. This appeal emphasizes the urgency of global collaboration among clinicians, researchers, policymakers, and industry leaders to translate scientific progress into tangible improvements in patient care.

By fostering innovation and integration, we can redefine the standards of care for anemia, inflammation, and infection, ultimately enhancing quality of life and reducing the global burden of these conditions. Let us seize this opportunity to shape a future where science and compassion converge for better health outcomes worldwide.

Prof. Dr. Christian Hönemann
Guest Editor

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Research

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13 pages, 1541 KB

Open AccessArticle

Elective Cardiopulmonary Bypass (CPB) Surgery After COVID-19: Vasoactive Needs and Early Complications—A Prospective Study

by Cornelia-Elena Predoi, Daniela Carmen Filipescu, Mihai Gabriel Stefan and Niculae Iordache

J. Clin. Med. 2025, 14(23), 8290; https://doi.org/10.3390/jcm14238290 - 21 Nov 2025

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Abstract

Background/Objectives: Whether a remote history of SARS-CoV-2 infection independently affects early haemodynamic stability after elective cardiopulmonary bypass (CPB) remains uncertain. We evaluated whether prior COVID-19 (>7 weeks before surgery) was associated with postoperative vasopressor requirements or early complications in adults undergoing elective CPB. Methods: We conducted a single-centre prospective cohort study including adults (≥18 years) scheduled for elective on-pump coronary, valve, or combined cardiac surgery between 1 August 2022 and 30 October 2023. Patients undergoing emergency procedures or surgery < 7 weeks after infection were excluded. The exposure was a documented history of COVID-19 for >7 weeks preoperatively. The primary outcome was postoperative vasopressor use within 24 h of ICU admission; secondary outcomes included inotrope use, arrhythmias, acute cardiac or respiratory failure, pneumonia, acute kidney injury (KDIGO), delirium, stroke, length of stay, and mortality. Multivariable logistic regression adjusted for age, CPB duration, obesity, anaemia, chronic kidney disease, sex, EuroSCORE I, left ventricular ejection fraction, and procedure type. Results: Of 351 screened patients, 280 elective CPB cases were analyzed; 101 (36.1%) had prior COVID-19. Vasopressor use occurred in 151/280 (53.9%) patients, with no difference between COVID and non-COVID groups (53.5% vs. 54.2%; p = 1.00). Prior COVID-19 was not associated with vasopressor requirement (adjusted OR 0.94, 95% CI 0.56–1.59). Independent predictors were longer CPB duration (aOR 2.80 per hour; p < 0.001) and older age (aOR 1.028 per year; p = 0.02). Secondary outcomes, including organ dysfunction and mortality, did not differ between groups. Conclusions: In adults undergoing elective CPB ≥ 7 weeks after SARS-CoV-2 infection, prior COVID-19 did not increase early vasopressor needs or short-term postoperative complications. Haemodynamic requirements were primarily driven by CPB duration and age. Further research using dose-standardized vasoactive metrics and formal COVID-19 severity stratification is warranted. Full article

(This article belongs to the Special Issue New Insights in the Diagnosis, Treatment and Monitoring of Anemia, Inflammation and Infection)

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28 pages, 4044 KB

Open AccessReview

Endotoxin’s Impact on Organism: From Immune Activation to Tolerance and Beyond

by Kacper Roszak, Konkonika Roy, Justyna Sobocińska, Paulina Spisz, Tomasz Jędrzejewski and Sylwia Wrotek

J. Clin. Med. 2025, 14(18), 6478; https://doi.org/10.3390/jcm14186478 - 14 Sep 2025

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Abstract

Endotoxin, a key component of Gram-negative bacterial membranes, remains a central focus in understanding host–pathogen interactions and immune modulation. In this review, we examine the multifaceted roles of endotoxin, with particular emphasis on how its structural variants modulate host immune recognition and inflammatory signalling. We explore the complex mechanisms by which endotoxin activates innate immune pathways and how these responses evolve under repeated or chronic exposure conditions. Special attention is given to the phenomenon of endotoxin tolerance, an adaptive reprogramming of immune cells that can profoundly alter inflammatory outcomes. While this tolerance serves as a protective mechanism against hyperinflammation, mounting evidence suggests that it may have a “dark side”, potentially impairing immune surveillance and promoting disease states such as cancer. We also discuss emerging clinical and therapeutic strategies that harness or counteract endotoxin-driven responses, from vaccine adjuvants to anti-sepsis interventions. By integrating recent findings from immunology, microbiology, and translational medicine, this review sheds light on the dual nature of endotoxin and its far-reaching implications for human health. Full article

(This article belongs to the Special Issue New Insights in the Diagnosis, Treatment and Monitoring of Anemia, Inflammation and Infection)

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New Insights in the Diagnosis, Treatment and Monitoring of Anemia, Inflammation and Infection

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