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Sepsis: frontiers in supportive care, organisation and research

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Abstract

Because of its high incidence and clinical complexity, sepsis is a major challenge to clinicians and researchers and a global burden to healthcare systems and society. Despite recent progress, short- and long-term morbidity, mortality and costs remain high in both developed and developing countries. Thus, further improvements in supportive interventions and organisation of care are likely to have a substantial impact upon global health. In this narrative review, invited experts describe the challenges and progress to be made in sepsis research and care in the near future. We focus on supportive care (pulmonary, endocrine, renal, and nutritional support, mediator modulation and precision medicine), organisational themes (guidelines, outcome measures and stakeholder involvement) and clinical research as key areas to improving the care and outcomes of patients with sepsis.

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Authors and Affiliations

  1. Department of Intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Anders Perner

  2. St. George’s Healthcare NHS Trust, St George’s University of London, London, UK

    Andrew Rhodes

  3. Department of Intensive Care, Wesley Hospital and Princess Alexandra Hospital, University of Queensland, St Lucia, Australia

    Bala Venkatesh

  4. University of Sydney, Sydney, Australia

    Bala Venkatesh

  5. Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA

    Derek C. Angus

  6. Multidisciplinary Intensive Care Research Organization (MICRO), Wellcome Trust-HRB Clinical Research, Dublin, Ireland

    Ignacio Martin-loeches

  7. Department of Clinical Medicine, Trinity Centre for Health Sciences, St James’s University Hospital, Dublin, Ireland

    Ignacio Martin-loeches

  8. CIBER enfermedades respiratorias (CIBERES), Critical Care Center, Madrid, Spain

    Ignacio Martin-loeches

  9. Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Charles Preiser & Jean-Louis Vincent

  10. Departments of Surgery and Critical Care Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Canada

    John Marshall

  11. Jena University Hospital, Jena, Germany

    Konrad Reinhart

  12. Division of Intensive Care and Emergency Medicine, Medical University Innsbruck, Innsbruck, Austria

    Michael Joannidis

  13. Infectious Diseases Division, The Alpert Medical School of Brown University, Providence, RI, USA

    Steven M. Opal

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  1. Anders Perner
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  2. Andrew Rhodes
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  3. Bala Venkatesh
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  4. Derek C. Angus
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  7. Jean-Louis Vincent
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  8. John Marshall
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  9. Konrad Reinhart
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  10. Michael Joannidis
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  11. Steven M. Opal
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Correspondence to Anders Perner.

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Conflicts of interest

AP is member of the steering committee and national investigator of a vasopressin trial in septic shock sponsored by Ferring Pharmaceuticals; his department is reimbursed for his time. The department also receives research funding from Fresenius Kabi and CSL Behring. DCA has received consulting fees from Abbott, Bayer, Beckman-Coulter, Biocartis, GenMark, GlaxoSmithKline, and Sobi for advice on sepsis trial design and is paid by Ferring for his participation on the Trial Steering Committee of the Sepsis-ACT multicenter trial of selepressin for septic shock. IML has received supporting grants from Gilead and Bayer. JM is a member of the DSMB for a study conducted by AKPA Pharma, a member of the steering committee for a trial of endotoxin removal sponsored by Spectral Medical, and a consultant for Regeneron. JCP is a consultant or speaker for Aguettant, Baxter, Fresenius, Nestlé and Nutricia. KR is a consultant for Adrenomed (Adrecizumab, antibody against adrenomedullin) and holds equity in InflaRx (IFX-1, antibody against C5a). MJ is a consultant or speaker for Baxter, Fresenius, Asahi Kasei, Astute and CLS Behring. SO’s institution receives grants from Ferring (selepressin), Asahi Kasei (soluble thrombomodulin) and Biocartis (rapid genomic diagnostics) for their clinical trials in sepsis. He is a consultant for the following companies: Cyon, Biotest, Arsanis, Aridis, Debiopharma, Battelle and immunexpress.

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Perner, A., Rhodes, A., Venkatesh, B. et al. Sepsis: frontiers in supportive care, organisation and research. Intensive Care Med 43, 496–508 (2017). https://doi.org/10.1007/s00134-017-4677-4

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