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Biomedicines
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Sepsis: Diagnostics and Therapeutics
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Sepsis: Diagnostics and Therapeutics

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 13698

Special Issue Editors

Dr. Tsukasa Nakamura

E-Mail Website
Guest Editor
Division of Nephrology, Department of Internal Medicine, Kashiwa Forest Clinic, Kashiwa, Chiba, Japan
Interests: sepsis; critical care medicine; renal replacement therapy; LDL-apheresis; diabetic nephropathy
Special Issues, Collections and Topics in MDPI journals
Dr. Eiichi Sato

E-Mail Website
Guest Editor
Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Chiba, Japan
Interests: sepsis; acute kidney injury; chronic kidney disease; hemodialysis therapy; diabetic nephropathy; aquaporin 2
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The recently-modified Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defines sepsis as a “life-threatening organ dysfunction caused by a dysregulated host response to infection” and septic shock as “a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone”. Sepsis-3 guidelines still prompt debate and discussion, such as the requirement for a serum lactate level to diagnose septic shock, or use of the quick sepsis-related organ failure assessment (SOFA) score in the diagnosis of sepsis. Further detailed verification is required for reevaluation and future revision of Sepsis-3.

This Special Issue of the Biomedicines will focus on sepsis, and report new insights into epidemiology, pathophysiology, diagnosis, biomarkers, and treatment. In addition, other morbidities and renal replacement therapy, including acute kidney injury and hemodiafiltration, are associated with sepsis, and submissions dealing with these conditions are welcome.

This Special Issue is jointly organized between IJMS and Biomedicines journals. According to the Aims and Scope of these journals, articles showing basic studies in biochemistry, molecular biology, and molecular medicine can be submitted to IJMS, while articles presenting more clinical content can be submitted to Biomedicines.

Prof. Tsukasa Nakamura
Dr. Eiichi Sato
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Sepsis-3
  • infection
  • septic shock
  • SOFA
  • organ dysfunction
  • acute kidney injury
  • renal replacement therapy
  • hemodiafiltration
  • biomarkers
  • therapeutics

Published Papers (3 papers)

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Research

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17 pages, 2891 KiB  
Article
Hemoadsorption with CytoSorb in Septic Shock Reduces Catecholamine Requirements and In-Hospital Mortality: A Single-Center Retrospective ‘Genetic’ Matched Analysis
by Christopher Rugg, Riko Klose, Rouven Hornung, Nicole Innerhofer, Mirjam Bachler, Stefan Schmid, Dietmar Fries and Mathias Ströhle
Biomedicines 2020, 8(12), 539; https://doi.org/10.3390/biomedicines8120539 - 26 Nov 2020
Cited by 49 | Viewed by 4761
Abstract
Septic shock is a major burden to healthcare with mortality rates remaining high. Blood purification techniques aim to reduce cytokine levels and resultant organ failure. Regarding septic shock, hemoadsorption via CytoSorb seems promising, but the main effects on organ failure and mortality remain [...] Read more.
Septic shock is a major burden to healthcare with mortality rates remaining high. Blood purification techniques aim to reduce cytokine levels and resultant organ failure. Regarding septic shock, hemoadsorption via CytoSorb seems promising, but the main effects on organ failure and mortality remain unclear. In this retrospective single-center study, septic shock patients receiving CytoSorb in addition to renal replacement therapy (n = 42) were analyzed and compared to matched controls (n = 42). A generalized propensity-score and Mahalanobis distance matching method (‘genetic’ matching) was applied. Baseline comparability was high. Differences were merely present in higher initial Sequential Organ Failure Assessment (SOFA) scores (median and interquartile range: 13.0 (12.0–14.75) vs. 12.0 (9.0–14.0)) and requirements of norepinephrine equivalents (0.54 (0.25–0.81) vs. 0.25 (0.05–0.54) µg/kg/min) in the CytoSorb group. While remaining fairly constant in the controls, the catecholamines decreased to 0.26 (0.11–0.40) µg/kg/min within 24 h after initiation of CytoSorb therapy. In-hospital mortality was significantly lower in the CytoSorb group (35.7% vs. 61.9%; p = 0.015). Risk factors for mortality within the CytoSorb group were high lactate levels and low thrombocyte counts prior to initiation. Hereby, a cut-off value of 7.5 mmol/L lactate predicted mortality with high specificity (88.9%). Thus, high lactate levels may indicate absent benefits when confronted with septic shock patients considered eligible for CytoSorb therapy. Full article
(This article belongs to the Special Issue Sepsis: Diagnostics and Therapeutics)
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Review

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23 pages, 538 KiB  
Review
Novel Diagnostics and Therapeutics in Sepsis
by Kieran Leong, Bhavita Gaglani, Ashish K. Khanna and Michael T. McCurdy
Biomedicines 2021, 9(3), 311; https://doi.org/10.3390/biomedicines9030311 - 18 Mar 2021
Cited by 8 | Viewed by 3975
Abstract
Sepsis management demands early diagnosis and timely treatment that includes source control, antimicrobial therapy, and resuscitation. Currently employed diagnostic tools are ill-equipped to rapidly diagnose sepsis and isolate the offending pathogen, which limits the ability to offer targeted and lowest-toxicity treatment. Cutting edge [...] Read more.
Sepsis management demands early diagnosis and timely treatment that includes source control, antimicrobial therapy, and resuscitation. Currently employed diagnostic tools are ill-equipped to rapidly diagnose sepsis and isolate the offending pathogen, which limits the ability to offer targeted and lowest-toxicity treatment. Cutting edge diagnostics and therapeutics in development may improve time to diagnosis and address two broad management principles: (1) source control by removing the molecular infectious stimulus of sepsis, and (2) attenuation of the pathological immune response allowing the body to heal. This review addresses novel diagnostics and therapeutics and their role in the management of sepsis. Full article
(This article belongs to the Special Issue Sepsis: Diagnostics and Therapeutics)
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15 pages, 602 KiB  
Review
Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection
by Shang-Kai Hung, Hao-Min Lan, Shih-Tsung Han, Chin-Chieh Wu and Kuan-Fu Chen
Biomedicines 2020, 8(11), 494; https://doi.org/10.3390/biomedicines8110494 - 12 Nov 2020
Cited by 40 | Viewed by 4281
Abstract
Sepsis was recently redefined as a life-threatening disease involving organ dysfunction caused by a dysregulated host response to infection. Biomarkers play an important role in early detection, diagnosis, and prognostication. We reviewed six promising biomarkers for detecting sepsis and systemic infection, including C-reactive [...] Read more.
Sepsis was recently redefined as a life-threatening disease involving organ dysfunction caused by a dysregulated host response to infection. Biomarkers play an important role in early detection, diagnosis, and prognostication. We reviewed six promising biomarkers for detecting sepsis and systemic infection, including C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), CD64, presepsin, and sTREM-1. Among the recent studies, we found the following risks of bias: only a few studies adopted the random or consecutive sampling strategy; extensive case-control analysis, which worsened the over-estimated performance; most of the studies used post hoc cutoff values; and heterogeneity with respect to the inclusion criteria, small sample sizes, and different quantitative synthesis methods applied in meta-analyses. We recommend that CD64 and presepsin should be considered as the most promising biomarkers for diagnosing sepsis. Future studies should enroll a larger sample size with a cohort rather than a case-control study design. A random or consecutive study design with a pre-specified laboratory threshold, consistent sampling timing, and an updated definition of sepsis will also increase the reliability of the studies. Further investigations of appropriate specimens, testing assays, and cutoff levels for specific biomarkers are also warranted. Full article
(This article belongs to the Special Issue Sepsis: Diagnostics and Therapeutics)
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