Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jan 9, 2022; 11(1): 1-21
Published online Jan 9, 2022. doi: 10.5492/wjccm.v11.i1.1
Precision medicine in sepsis and septic shock: From omics to clinical tools
Juan Carlos Ruiz-Rodriguez, Erika P Plata-Menchaca, Luis Chiscano-Camón, Adolfo Ruiz-Sanmartin, Marcos Pérez-Carrasco, Clara Palmada, Vicent Ribas, Mónica Martínez-Gallo, Manuel Hernández-González, Juan J Gonzalez-Lopez, Nieves Larrosa, Ricard Ferrer
Juan Carlos Ruiz-Rodriguez, Luis Chiscano-Camón, Adolfo Ruiz-Sanmartin, Marcos Pérez-Carrasco, Clara Palmada, Ricard Ferrer, Intensive Care Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
Juan Carlos Ruiz-Rodriguez, Erika P Plata-Menchaca, Luis Chiscano-Camón, Adolfo Ruiz-Sanmartin, Marcos Pérez-Carrasco, Ricard Ferrer, Shock, Organ Dysfunction and Resuscitation Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
Juan Carlos Ruiz-Rodriguez, Luis Chiscano-Camón, Adolfo Ruiz-Sanmartin, Ricard Ferrer, Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
Erika P Plata-Menchaca, Department of Intensive Care, Hospital Clínic de Barcelona, Barcelona 08036, Spain
Vicent Ribas, Data Analytics in Medicine, Digital Health Unit, Eurecat, Centre Tecnològic de Catalunya, Barcelona 08005, Spain
Mónica Martínez-Gallo, Manuel Hernández-González, Immunology Division, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
Mónica Martínez-Gallo, Manuel Hernández-González, Diagnostic Immunology Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
Mónica Martínez-Gallo, Manuel Hernández-González, Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
Juan J Gonzalez-Lopez, Nieves Larrosa, Department of Clinical Microbiology, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona 08035, Spain
Juan J Gonzalez-Lopez, Nieves Larrosa, Department of Microbiology and Genetics, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
Author contributions: Ruiz-Rodríguez JC contributed to manuscript design, conception, and coordination; Plata-Menchaca EP organized the manuscript generation process and revised the style and format of the manuscript; Ruiz-Rodríguez JC, Plata-Menchaca EP, Chiscano-Camón LS, Ruiz-Sanmartin A, Pérez-Carrasco M, Palmada C, Ribas V, Gallo MM, Hernández M, González-López JJ, Larrosa MN and Ferrer R provided important intellectual contributions to each section of the manuscript, including performance of writing and revision; all authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Juan Carlos Ruiz-Rodriguez, MD, PhD, Consultant Physician-Scientist, Intensive Care Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, 119, Passeig de la Vall d'Hebron, Barcelona 08035, Spain. jcruiz@vhebron.net
Received: April 26, 2021
Peer-review started: April 26, 2021
First decision: June 17, 2021
Revised: June 23, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 9, 2022
Processing time: 253 Days and 18.4 Hours
Abstract

Sepsis is a heterogeneous disease with variable clinical course and several clinical phenotypes. As it is associated with an increased risk of death, patients with this condition are candidates for receipt of a very well-structured and protocolized treatment. All patients should receive the fundamental pillars of sepsis management, which are infection control, initial resuscitation, and multiorgan support. However, specific subgroups of patients may benefit from a personalized approach with interventions targeted towards specific pathophysiological mechanisms. Herein, we will review the framework for identifying subpopulations of patients with sepsis, septic shock, and multiorgan dysfunction who may benefit from specific therapies. Some of these approaches are still in the early stages of research, while others are already in routine use in clinical practice, but together will help in the effective generation and safe implementation of precision medicine in sepsis.

Keywords: Sepsis; Septic shock; Organ dysfunction; Precision medicine; Biomarkers; Phenotype; Endotype

Core Tip: Sepsis is a heterogeneous disease with different clinical courses and several clinical phenotypes. Precision medicine in sepsis allows the identification of specific subgroups of patients who may benefit from a personalized approach with interventions targeted towards specific pathophysiological mechanisms.