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Updated: Sep 7, 2025

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Redefining critical illness.

David M Maslove1,2, Benjamin Tang3, Manu Shankar-Hari4,5

  • 1Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada. david.maslove@queensu.ca.

Nature Medicine
|June 17, 2022
PubMed
Summary
This summary is machine-generated.

Critical care medicine should move beyond syndrome-based diagnoses to focus on underlying biological changes. This approach, supported by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) research, promises more precise treatments and better patient outcomes.

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Area of Science:

  • Critical care medicine
  • Translational research
  • Pathobiology

Background:

  • Current critical care medicine relies on syndromes, which are heterogeneous and may respond variably to treatments.
  • Evidence from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection highlights limitations of the syndrome-based framework.

Purpose of the Study:

  • To propose a shift from syndrome-based classification to a focus on underlying biological mechanisms in critical illness.
  • To explore how recent basic science and clinical research can inform a new conceptual model for critical illness.

Main Methods:

  • Review of recent findings in basic science and clinical research in critical care.
  • Discussion of how these findings can inform a new conceptual model of critical illness.

Main Results:

  • The current syndrome-based framework for critical illness may be inadequate.
  • Focusing on underlying biological changes offers a more precise approach to understanding and treating critical illness.

Conclusions:

  • A new conceptual model de-emphasizing syndromes and focusing on biological changes is proposed.
  • This approach is hypothesized to accelerate research, improve understanding of critical illness pathobiology, and enhance clinical practice and trial design.