Redefining critical illness
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
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.
Date Issued
2022-06
Date Acceptance
2022-04-28
Citation
Nature Medicine, 2022, 28 (6), pp.1141-1148
ISSN
1078-8956
Publisher
Springer Science and Business Media LLC
Start Page
1141
End Page
1148
Journal / Book Title
Nature Medicine
Volume
28
Issue
6
Copyright Statement
© Springer Nature America, Inc. 2022. The final publication is available at Springer via https://doi.org/10.1038/s41591-022-01843-x
Sponsor
NIHR
Identifier
https://www.nature.com/articles/s41591-022-01843-x
Subjects
Immunology
11 Medical and Health Sciences
Publication Status
Published
Date Publish Online
2022-06-17