Metabolic footprint of sepsis and septic shock: A narrative review

Core Tip

Core Tip: Sepsis remains a cause of significant morbidity and mortality despite recent advances. Moreover, patient’s response to therapy and clinical prognosis is often difficult to accurately predict. Given the heterogeneous and multifactorial nature of disease, broad therapeutic approaches often fail to reduce mortality. Thus, there is a critical need for a better understanding of these complex, multifactorial conditions driven by diverse biological insults and causes. Biomarkers such as procalcitonin, presepsin, interleukin-6, and C-reactive protein are frequently used in diagnosing and monitoring sepsis, but they are far from ideal. Human metabolic activity is extremely sensitive to the surrounding microenvironment, with metabolite profiles reflecting combined influences from transcriptional, translational, and environmental factors. Hence, metabolites are a highly promising class of biomarkers which may be exploited to detect disease presence, progression, and therapeutic response. Emerging data suggests that early introduction of metabolomic data into routine critical care practice may enable more precise severity identification, targeted therapeutic strategies, and improved outcomes for patients with sepsis and septic shock.