Sepsis phenotypes, subphenotypes, and endotypes: are they ready for bedside care?

Area of Science:

• Critical Care Medicine
• Immunology
• Genomics

Background:

• Sepsis is a major global health challenge with high mortality rates.
• Current sepsis treatments lack efficacy due to significant patient heterogeneity.
• Advances in understanding sepsis phenotypes are crucial for therapeutic development.

Purpose of the Study:

• To review recent literature on sepsis phenotypes and their implications.
• To explore the potential for targeted research and therapeutic interventions based on sepsis subtypes.
• To highlight how understanding sepsis heterogeneity can improve patient outcomes.

Main Methods:

• Analysis of clinical parameters, including vital sign trajectories.
• Investigation of microbial factors and novel biomarkers.
• Application of multiomics approaches (genomics, transcriptomics, proteomics, metabolomics).

Main Results:

• Numerous sepsis phenotypes, subphenotypes, and endotypes have been identified.
• Multiomics studies reveal significant population differences, especially in immunosuppressed sepsis.
• Biomarker investigations show potential for improved diagnostic accuracy and complication identification.

Conclusions:

• Validated sepsis phenotypes can guide therapies more effectively than universal approaches.
• Novel biomarkers and multiomics data offer promise for personalized sepsis management.
• Further research is needed to overcome reproducibility and implementation challenges for bedside application.