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Septic shock: Past, present, and perspectives.

Erika P Plata-Menchaca1, Orlando Rubén Pérez-Nieto2, Eduardo Kattan3

  • 1Shock, Organ Dysfunction and Resuscitation Group, Intensive Care Department, Vall'd'Hebron University Hospital, Vall d'Hebron Hospital Campus, Spain; Department of Medicine, Universitat Autònoma de Barcelona (Cerdanyola del Vallès), Bellaterra, Barcelona, Spain.

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Summary
This summary is machine-generated.

Septic shock, a severe infection complication, has seen improved survival through structured care. Future advancements rely on precision medicine and new technologies for personalized patient treatment.

Keywords:
Artificial intelligenceCritical careFluid therapyHemodynamic monitoringPrecision medicineSepsisSeptic shockVasopressor agents

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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Translational Medicine

Background:

  • Septic shock is a life-threatening condition characterized by circulatory, cellular, and metabolic dysfunction.
  • Historical understanding has evolved from
  • blood poisoning
  • to sepsis as a systemic syndrome, with significant mortality.
  • The Surviving Sepsis Campaign has guided structured treatment, improving survival rates.

Purpose of the Study:

  • To review the evolution of septic shock management.
  • To highlight current treatment strategies and ongoing debates.
  • To explore future directions in precision medicine and technology for sepsis care.

Main Methods:

  • Review of historical concepts and clinical trial evolution.
  • Analysis of current management guidelines emphasizing rapid recognition, antimicrobials, source control, fluid resuscitation, and vasopressors.
  • Discussion of emerging technologies like machine learning, multi-omics, and bedside monitoring tools.

Main Results:

  • Management has advanced with structured protocols and campaigns, leading to gradual survival improvements.
  • Significant patient heterogeneity complicates decision-making, with ongoing debates on fluid thresholds, vasopressor timing, and adjunctive therapies.
  • Precision medicine, machine learning, and multi-omics show promise for risk prediction, subphenotype identification, and personalized treatment.

Conclusions:

  • Septic shock management has progressed substantially, but challenges remain due to patient heterogeneity.
  • Emerging technologies and precision medicine offer potential for refining diagnosis, prognostication, and individualized treatment.
  • Addressing global disparities in access to care is crucial for improving overall outcomes and survivorship.