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Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 7875

Special Issue Editor

Dr. Silvia De Rosa

E-Mail Website
Guest Editor
1. Centre for Medical Sciences—CISMed, University of Trento, Via S. Maria, Maddalena 1, 38122 Trento, Italy
2. Anesthesia and Intensive Care, Santa, Chiara Regional Hospital, APSS, Trento, Italy
Interests: acute brain injury; acute kidney injury; blood purification in sepsis; airway management; infectious disease; extracorporeal organ support; nutrition and metabolism in critical care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to present this Special Issue of the International Journal of Molecular Sciences: “Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition”, as Volume 1 of the Special Issue was successful.

The conceptual framework for the diagnosis of sepsis, septic shock and endotoxic shock has multiple steps, including an initial evaluation of the etiology and clinical features, assessment of the primary hemodynamic manifestations, and consideration of the alterations in cellular biology and the degree of local tissue injury. The prompt diagnosis of septic shock begins with obtainment of the patient’s medical history and the performance of a physical examination to identify the signs and symptoms of infection; the patient may also require focused ultrasonography to recognize more complex physiologic manifestations of shock. The identification of biomarkers is particularly important to understand molecular mechanisms and diagnose sepsis, enabling early intervention, which can reduce the risk of death. In fact, a sample treatment algorithm for septic shock typically proceeds through the rescue, optimization, stabilization, and de-escalation of care. Many adjunctive treatments in septic shock target perturbations in the innate immune response and coagulation cascade. An example of this is extracorporeal blood purification therapy, which has been proposed to improve outcomes in patients with sepsis. Therefore, IJMS is proud to offer this platform to promote and highlight valuable research on “Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition”.

Dr. Silvia De Rosa
Guest Editor

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.

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Keywords

  • antibiotics
  • biomarkers
  • blood purification in sepsis
  • endotoxic shock
  • imaging
  • infectious disease
  • resuscitation
  • biomarkers
  • septic shock
  • sepsis-associated AKI

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Published Papers (3 papers)

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14 pages, 3160 KiB  
Article
Free Radical–Associated Gene Signature Predicts Survival in Sepsis Patients
by Anlin Feng, Marissa D. Pokharel, Ying Liang, Wenli Ma, Saurabh Aggarwal, Stephen M. Black and Ting Wang
Int. J. Mol. Sci. 2024, 25(8), 4574; https://doi.org/10.3390/ijms25084574 - 22 Apr 2024
Viewed by 1041
Abstract
Sepsis continues to overwhelm hospital systems with its high mortality rate and prevalence. A strategy to reduce the strain of sepsis on hospital systems is to develop a diagnostic/prognostic measure that identifies patients who are more susceptible to septic death. Current biomarkers fail [...] Read more.
Sepsis continues to overwhelm hospital systems with its high mortality rate and prevalence. A strategy to reduce the strain of sepsis on hospital systems is to develop a diagnostic/prognostic measure that identifies patients who are more susceptible to septic death. Current biomarkers fail to achieve this outcome, as they only have moderate diagnostic power and limited prognostic capabilities. Sepsis disrupts a multitude of pathways in many different organ systems, making the identification of a single powerful biomarker difficult to achieve. However, a common feature of many of these perturbed pathways is the increased generation of reactive oxygen species (ROS), which can alter gene expression, changes in which may precede the clinical manifestation of severe sepsis. Therefore, the aim of this study was to evaluate whether ROS-related circulating molecular signature can be used as a tool to predict sepsis survival. Here we created a ROS-related gene signature and used two Gene Expression Omnibus datasets from whole blood samples of septic patients to generate a 37-gene molecular signature that can predict survival of sepsis patients. Our results indicate that peripheral blood gene expression data can be used to predict the survival of sepsis patients by assessing the gene expression pattern of free radical–associated -related genes in patients, warranting further exploration. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition)
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Review

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37 pages, 1610 KiB  
Review
Navigating the Modern Landscape of Sepsis: Advances in Diagnosis and Treatment
by Jin Ho Jang, Eunjeong Choi, Taehwa Kim, Hye Ju Yeo, Doosoo Jeon, Yun Seong Kim and Woo Hyun Cho
Int. J. Mol. Sci. 2024, 25(13), 7396; https://doi.org/10.3390/ijms25137396 - 5 Jul 2024
Viewed by 1996
Abstract
Sepsis poses a significant threat to human health due to its high morbidity and mortality rates worldwide. Traditional diagnostic methods for identifying sepsis or its causative organisms are time-consuming and contribute to a high mortality rate. Biomarkers have been developed to overcome these [...] Read more.
Sepsis poses a significant threat to human health due to its high morbidity and mortality rates worldwide. Traditional diagnostic methods for identifying sepsis or its causative organisms are time-consuming and contribute to a high mortality rate. Biomarkers have been developed to overcome these limitations and are currently used for sepsis diagnosis, prognosis prediction, and treatment response assessment. Over the past few decades, more than 250 biomarkers have been identified, a few of which have been used in clinical decision-making. Consistent with the limitations of diagnosing sepsis, there is currently no specific treatment for sepsis. Currently, the general treatment for sepsis is conservative and includes timely antibiotic use and hemodynamic support. When planning sepsis-specific treatment, it is important to select the most suitable patient, considering the heterogeneous nature of sepsis. This comprehensive review summarizes current and evolving biomarkers and therapeutic approaches for sepsis. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition)
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11 pages, 610 KiB  
Review
Acute Kidney Injury in Sepsis
by Telma Pais, Sofia Jorge and José António Lopes
Int. J. Mol. Sci. 2024, 25(11), 5924; https://doi.org/10.3390/ijms25115924 - 29 May 2024
Viewed by 4198
Abstract
Sepsis-associated kidney injury is common in critically ill patients and significantly increases morbidity and mortality rates. Several complex pathophysiological factors contribute to its presentation and perpetuation, including macrocirculatory and microcirculatory changes, mitochondrial dysfunction, and metabolic reprogramming. Recovery from acute kidney injury (AKI) relies [...] Read more.
Sepsis-associated kidney injury is common in critically ill patients and significantly increases morbidity and mortality rates. Several complex pathophysiological factors contribute to its presentation and perpetuation, including macrocirculatory and microcirculatory changes, mitochondrial dysfunction, and metabolic reprogramming. Recovery from acute kidney injury (AKI) relies on the evolution towards adaptive mechanisms such as endothelial repair and tubular cell regeneration, while maladaptive repair increases the risk of progression to chronic kidney disease. Fundamental management strategies include early sepsis recognition and prompt treatment, through the administration of adequate antimicrobial agents, fluid resuscitation, and vasoactive agents as needed. In septic patients, organ-specific support is often required, particularly renal replacement therapy (RRT) in the setting of severe AKI, although ongoing debates persist regarding the ideal timing of initiation and dosing of RRT. A comprehensive approach integrating early recognition, targeted interventions, and close monitoring is essential to mitigate the burden of SA-AKI and improve patient outcomes in critical care settings. Full article
(This article belongs to the Special Issue Diagnostic and Therapeutic Advances in the Management of Sepsis and Septic Shock—2nd Edition)
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