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Heterogeneity in Sepsis: New Biological Evidence with Clinical Applications

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Annual Update in Intensive Care and Emergency Medicine 2019

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

Since the first consensus definition of sepsis almost three decades ago [1], our understanding of the clinical characteristics that prognosticate the outcome of this complex syndrome has improved [2], resulting in a simpler classification scheme [3]. The existing definitions, however, remain imprecise and the clinical diagnosis of sepsis corresponds poorly with post hoc presence of infection [4]. Furthermore, the outcome of sepsis depends on factors beyond patient signs and symptoms [5], including age [6], the infection source [7], and the timing and appropriateness of therapeutic interventions [8] (Fig. 40.1). There is currently a promising shift from predicting outcome to a pathobiology-driven understanding of the heterogeneity in the host response to sepsis, utilizing novel translational high throughput tools and analytic methods to define distinct host response subgroups. It is now well recognized that biological markers improve the classification of sepsis and can facilitate identification of distinct patient subclasses, or endotypes.

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Author information

Authors and Affiliations

  1. Cardiovascular Research Institute, University of California-San Francisco, San Francisco, CA, USA

    A. Leligdowicz & M. A. Matthay

  2. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada

    A. Leligdowicz

  3. Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA

    M. A. Matthay

  4. Departments of Medicine and Anesthesia, University of California-San Francisco, San Francisco, CA, USA

    M. A. Matthay

Authors
  1. A. Leligdowicz
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  2. M. A. Matthay
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Corresponding author

Correspondence to A. Leligdowicz .

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Editors and Affiliations

  1. Dept. of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent

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Leligdowicz, A., Matthay, M.A. (2019). Heterogeneity in Sepsis: New Biological Evidence with Clinical Applications. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2019. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-06067-1_40

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  • DOI: https://doi.org/10.1007/978-3-030-06067-1_40

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-06066-4

  • Online ISBN: 978-3-030-06067-1

  • eBook Packages: MedicineMedicine (R0)

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