免疫抑制患者，特别是癌症患者，在人口中所占比例越来越大，尤其是癌症发病率随着人口增长和老龄化而上升。由于中性粒细胞减少、淋巴细胞减少以及 T 和 B 细胞损伤等多种免疫缺陷，这些患者发生严重感染（包括脓毒症和脓毒性休克）的风险较高。这些免疫学特征的多样性和复杂性，由于同时使用免疫抑制疗法（例如皮质类固醇、细胞毒性药物和免疫疗法）而变得更加复杂，再加上天然保护屏障的破坏（例如粘膜损伤、慢性留置导管和改变）解剖结构），增加了各种感染的风险。这些和其他类似脓毒症的病症提出了巨大的诊断和治疗挑战。增加这些患者进展为感染性休克风险的因素包括高龄、既往合并症、虚弱、癌症类型、免疫抑制的严重程度、低蛋白血症、低磷酸盐血症、革兰氏阴性菌血症以及对初始治疗反应的类型和时间。治疗。由于临床实践存在偏差，患有脓毒症或脓毒性休克的易受感染的癌症患者的治疗方法各不相同，这可能导致延迟获得重症监护和更糟糕的结果。虽然脓毒性休克通常与恶性肿瘤患者的不良预后相关，但随着时间的推移，生存率已显着提高。因此，通过新的范式理解和解决癌症患者的独特需求，包括将创新技术融入我们的医疗保健系统（例如无线技术、医疗信息学、精准医疗）、有针对性的管理策略和稳健的临床实践，包括早期识别和诊断，再加上及时入住提倡多学科治疗的高级护理机构，对于改善其预后和总体生存率至关重要。© 2024。作者。

Immunosuppressed patients, particularly those with cancer, represent a momentous and increasing portion of the population, especially as cancer incidence rises with population growth and aging. These patients are at a heightened risk of developing severe infections, including sepsis and septic shock, due to multiple immunologic defects such as neutropenia, lymphopenia, and T and B-cell impairment. The diverse and complex nature of these immunologic profiles, compounded by the concomitant use of immunosuppressive therapies (e.g., corticosteroids, cytotoxic drugs, and immunotherapy), superimposed by the breakage of natural protective barriers (e.g., mucosal damage, chronic indwelling catheters, and alterations of anatomical structures), increases the risk of various infections. These and other conditions that mimic sepsis pose substantial diagnostic and therapeutic challenges. Factors that elevate the risk of progression to septic shock in these patients include advanced age, pre-existing comorbidities, frailty, type of cancer, the severity of immunosuppression, hypoalbuminemia, hypophosphatemia, Gram-negative bacteremia, and type and timing of responses to initial treatment. The management of vulnerable cancer patients with sepsis or septic shock varies due to biased clinical practices that may result in delayed access to intensive care and worse outcomes. While septic shock is typically associated with poor outcomes in patients with malignancies, survival has significantly improved over time. Therefore, understanding and addressing the unique needs of cancer patients through a new paradigm, which includes the integration of innovative technologies into our healthcare system (e.g., wireless technologies, medical informatics, precision medicine), targeted management strategies, and robust clinical practices, including early identification and diagnosis, coupled with prompt admission to high-level care facilities that promote a multidisciplinary approach, is crucial for improving their prognosis and overall survival rates.© 2024. The Author(s).