Abstract
Original language | English |
---|---|
Pages (from-to) | 1141-1148 |
Number of pages | 8 |
Journal | Nature medicine |
Volume | 28 |
Issue number | 6 |
DOIs | |
Publication status | Published - 1 Jun 2022 |
Access to Document
Other files and links
Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: Nature medicine, Vol. 28, No. 6, 01.06.2022, p. 1141-1148.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Redefining critical illness
AU - Maslove, David M.
AU - Tang, Benjamin
AU - Shankar-Hari, Manu
AU - Lawler, Patrick R.
AU - Angus, Derek C.
AU - Baillie, J. Kenneth
AU - Baron, Rebecca M.
AU - Bauer, Michael
AU - Buchman, Timothy G.
AU - Calfee, Carolyn S.
AU - dos Santos, Claudia C.
AU - Giamarellos-Bourboulis, Evangelos J.
AU - Gordon, Anthony C.
AU - Kellum, John A.
AU - Knight, Julian C.
AU - Leligdowicz, Aleksandra
AU - McAuley, Daniel F.
AU - McLean, Anthony S.
AU - Menon, David K.
AU - Meyer, Nuala J.
AU - Moldawer, Lyle L.
AU - Reddy, Kiran
AU - Reilly, John P.
AU - Russell, James A.
AU - Sevransky, Jonathan E.
AU - Seymour, Christopher W.
AU - Shapiro, Nathan I.
AU - Singer, Mervyn
AU - Summers, Charlotte
AU - Sweeney, Timothy E.
AU - Thompson, B. Taylor
AU - van der Poll, Tom
AU - Venkatesh, Balasubramanian
AU - Walley, Keith R.
AU - Walsh, Timothy S.
AU - Ware, Lorraine B.
AU - Wong, Hector R.
AU - Zador, Zsolt E.
AU - Marshall, John C.
N1 - Funding Information: R.M.B. reports having served on advisory boards for Merck and Genentech. M.B. is a stockholder of SmartDyeLivery, a company developing nanodrugs for sepsis. T.G.B. has no direct conflicts of interest. His employer, Emory University, collects a stipend for his service as Editor-in-Chief of Critical Care Medicine from the Society of Critical Care Medicine. Emory University also collects a stipend from the US Government for his service as senior advisor to the Biomedical Advanced Research and Development Authority. C.S.C. receives grant funding from the NIH, US Food and Drug Administration, US Department of Defense, Quantum Leap Healthcare Collaborative and Roche-Genentech and has provided consulting services for Quark, Vasomune, Gen1e Life Sciences, Cellenkos, and Janssen. A.C.G. is supported by an NIHR Research Professorship (RP-2015-06-018) and the NIHR Imperial Biomedical Research Centre. Outside of this work he has received personal fees from 30 Respiratory paid to his institution. Outside the submitted work, D.F.M. reports personal fees from consultancy for GlaxoSmithKline, Boehringer Ingelheim, Bayer, Novartis, Sobi and Eli Lilly and from sitting on a Data Monitoring and Ethics Committee for trials undertaken by Vir Biotechnology and Faron Pharmaceuticals. In addition, his institution has received funds from grants from the National Institute for Health and Care Research (NIHR), the Wellcome Trust, Innovate-UK, the Medical Research Council (MRC) and the Northern Ireland HSC R&D Division. D.F.M. also holds a patent for an anti-inflammatory treatment issued to Queen’s University Belfast. D.F.M. was Director of Research for the UK Intensive Care Society (term ended in June 2021) and is NIHR/MRC Efficacy and Mechanism Evaluation Programme Director. D.K.M. reports grants from the European Union, the NIHR and the Canadian Institute for Advanced Research supporting the submitted work; grants from GlaxoSmithKline and Lantmannen; and consulting fees from Calico, GlaxoSmithKline, Lantmannen, NeuroTrauma Sciences and Integra Neurosciences outside the submitted work. L.L.M. reports grants and contracts from the NIGMS, NICHD, and NIAID (NIH), as well as subcontracts from Inflammatix and Beckman-Coulter through awards from BARDA (HHS). In addition, L.L.M. participates in clinical studies supported by RevImmune, Immunex, Faraday and Beckman-Coulter. J.A.R. reports patents owned by the University of British Columbia that are related to (1) the use of PCSK9 inhibitor(s) in sepsis and (2) the use of vasopressin in septic shock, as well as (3) a patent owned by Ferring Pharmaceuticals for the use of selepressin in septic shock. J.A.R. is an inventor on these patents. J.A.R. was a founder, director and shareholder in Cyon Therapeutics and is a shareholder in Molecular You Corp. J.A.R. is no longer actively consulting for any industry. J.A.R. reports receiving consulting fees in the last 3 years from SIB Therapeutics (developing a sepsis drug), Ferring Pharmaceuticals (manufactures vasopressin and is developing selepressin) and PAR Pharma (sells prepared bags of vasopressin). J.A.R. was a funded member of the Data and Safety Monitoring Board of a National Institutes of Health-sponsored trial of plasma in COVID-19 (PASS-IT-ON) (2020–2021). J.A.R. reports having received an investigator-initiated grant from Grifols (titled ‘Is HBP a mechanism of albuminʼs efficacy in human septic shock?’) that was provided to and administered by the University of British Columbia. J.A.R. has received four grants for COVID-19 research from the Canadian Institutes of Health Research and two grants from the St. Paul’s Foundation. J.A.R. was also a non-funded science advisor and member of the Government of Canada COVID-19 Therapeutics Task Force (2020–2021). N.I.S. reports research funding from the National Institutes of Health, Luminos, Inflammatix and Google and is a consultant for Diagnostic Robotics. M.S. has served on advisory boards for infection and sepsis-related projects from Abbott, AM Pharma, Aptarion, Biotest, Biomerieux, deePull, Pfizer, Roche, Safeguard Biosystems and Spiden, and from Deltex Medical, Fresenius and Nestle outside the submitted work. M.S. holds a patent owned by University College London related to a sulphide-releasing molecule for ischaemia-reperfusion injury and a pending patent for phytosterol use in sepsis. UCL also holds shares in Deltex Medical and receives research funding from the Medical Research Council, Wellcome Trust, NIHR, Innovate UK, the European Commission and the UCL Technology Fund. T.E.S. is stockholder in, and employee of, Inflammatix, which is developing a rapid test for sepsis endotypes. Outside the submitted work, B.T.T. reports personal fees from consultancy for Bayer and Genentech. B.V. reports being an NHMRC Investigator Fellow. Publisher Copyright: © 2022, Springer Nature America, Inc.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Research and practice in critical care medicine have long been defined by syndromes, which, despite being clinically recognizable entities, are, in fact, loose amalgams of heterogeneous states that may respond differently to therapy. Mounting translational evidence—supported by research on respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—suggests that the current syndrome-based framework of critical illness should be reconsidered. Here we discuss recent findings from basic science and clinical research in critical care and explore how these might inform a new conceptual model of critical illness. De-emphasizing syndromes, we focus on the underlying biological changes that underpin critical illness states and that may be amenable to treatment. We hypothesize that such an approach will accelerate critical care research, leading to a richer understanding of the pathobiology of critical illness and of the key determinants of patient outcomes. This, in turn, will support the design of more effective clinical trials and inform a more precise and more effective practice at the bedside.
AB - Research and practice in critical care medicine have long been defined by syndromes, which, despite being clinically recognizable entities, are, in fact, loose amalgams of heterogeneous states that may respond differently to therapy. Mounting translational evidence—supported by research on respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—suggests that the current syndrome-based framework of critical illness should be reconsidered. Here we discuss recent findings from basic science and clinical research in critical care and explore how these might inform a new conceptual model of critical illness. De-emphasizing syndromes, we focus on the underlying biological changes that underpin critical illness states and that may be amenable to treatment. We hypothesize that such an approach will accelerate critical care research, leading to a richer understanding of the pathobiology of critical illness and of the key determinants of patient outcomes. This, in turn, will support the design of more effective clinical trials and inform a more precise and more effective practice at the bedside.
UR - http://www.scopus.com/inward/record.url?scp=85132330581&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41591-022-01843-x
DO - https://doi.org/10.1038/s41591-022-01843-x
M3 - Article
C2 - 35715504
SN - 1078-8956
VL - 28
SP - 1141
EP - 1148
JO - Nature medicine
JF - Nature medicine
IS - 6
ER -