Immunoinflammatory Regulation of Esketamine in Septic Patients

Inclusion Criteria:

• 18 years old ≤ age ≤60 years old;

• SOFA score ≥2;

• Mechanical ventilation should be required for at least 24 hours when included in thestudy;

• Informed consent is obtained.

Exclusion Criteria:

• Age < 18 years old or ≥ 60 years old;

• Previous solid organ or bone marrow transplantation;

• Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.), orhematologic malignancies (leukemia and lymphoma, etc.);

• Received radiotherapy or chemotherapy within the past 30 days, or receivedimmunosuppressant drugs (tripterygium wilfordii, mycophenolate mofetil,cyclophosphamide, FK506, etc.), or continuous treatment with prednisolone more than 10 mg/day (or equivalent doses of the other hormones);

• Unstable angina pectoris or myocardial infarction in the past six months;

• Acute brain injury (traumatic brain injury, subarachnoid hemorrhage, acute ischemicstroke, acute intracranial hemorrhage, acute intracranial infection, etc.);

• Poorly controlled hypertension and congestive heart failure;

• Increased intraocular or intracranial pressure;

• Chronic kidney disease, received continuous renal replacement therapy in the past 30days, or acute renal failure requiring CRRT;

• Severe chronic liver disease (Child-Pugh class B or C);

• Alcohol dependence, mental illness or severe cognitive impairment;

• Pregnancy or lactation;

• Informed consent is not obtained.