Physiological and metabolic correlations in human sepsis. Invited commentary

Area of Science:

• Pathophysiology
• Metabolic Regulation
• Systems Biology

Background:

• Sepsis is characterized by a host response to infection.
• This response involves disordered metabolic control.
• Key metabolic shifts include increased gluconeogenesis and ketone body formation.

Purpose of the Study:

• To describe the metabolic derangements in sepsis.
• To introduce physiological state trajectories as a method to quantify these changes.
• To discuss the prognostic and therapeutic implications.

Main Methods:

• Analysis of metabolic pathways during septic response.
• Quantification of cardiorespiratory, vascular, and physiological compensation.
• Utilizing physiological state trajectories to assess metabolic derangements.

Main Results:

• Sepsis induces abnormal regulation of metabolic pathways.
• Substrate utilization is diverted, reducing oxidative energy metabolism.
• Physiological state trajectories reflect the magnitude of metabolic insufficiency.

Conclusions:

• Sepsis represents a disease of disordered metabolic control.
• Physiological state trajectories offer a quantitative measure of sepsis severity.
• These trajectories have significant prognostic and therapeutic implications.