Preprint Review Version 1 This version is not peer-reviewed

A Multivariate Phenotypical Approach of Sepsis and Septic Shock – a Comprehensive Narrative Literature Review

Alina Tita
,
Sebastian Isac
* ORCID logo ,
Teodora Isac
,
Cristina Martac
,
Teodorescu Geani-Danut
ORCID logo ,
Lavinia Jipa
,
Cristian Cobilinschi
ORCID logo ,
Bogdan Pavel
,
Maria-Daniela Tanasescu
,
Liliana Elena Mirea
ORCID logo ,
Gabriela Droc
ORCID logo
Version 1 : Received: 27 September 2024 / Approved: 27 September 2024 / Online: 27 September 2024 (09:35:03 CEST)

How to cite: Tita, A.; Isac, S.; Isac, T.; Martac, C.; Geani-Danut, T.; Jipa, L.; Cobilinschi, C.; Pavel, B.; Tanasescu, M.-D.; Mirea, L. E.; Droc, G. A Multivariate Phenotypical Approach of Sepsis and Septic Shock – a Comprehensive Narrative Literature Review. Preprints 2024, 2024092197. https://doi.org/10.20944/preprints202409.2197.v1 Tita, A.; Isac, S.; Isac, T.; Martac, C.; Geani-Danut, T.; Jipa, L.; Cobilinschi, C.; Pavel, B.; Tanasescu, M.-D.; Mirea, L. E.; Droc, G. A Multivariate Phenotypical Approach of Sepsis and Septic Shock – a Comprehensive Narrative Literature Review. Preprints 2024, 2024092197. https://doi.org/10.20944/preprints202409.2197.v1

Abstract

Despite medical advances, sepsis and septic shock remain one of the leading causes of mortality worldwide, with a high inter-individual variability in prognosis, clinical manifestations and response to treatment. Given the heterogeneity of sepsis and recent technological progress amongst machine learning analysis technique, a new, personalized approach in sepsis is being intensively studied. Despite the difficulties when tailoring a targeted approach, with the use of artificial intelligence-based pattern recognition, more and more publications are becoming available, highlighting novel factors that may intervene in the high heterogenicity of sepsis. This has led to the devise of a phenotypical approach in sepsis, further dividing patients based on host and trigger-related factors, clinical manifestations and progression towards organ deficiencies, dynamic prognosis algorithms and patient trajectory in the Intensive Care Unit (ICU). Host and trigger-related factors refer to patients’ comorbidities, body-mass index, age, temperature, immune response, type of bacteria and infection site. The progression to organ deficiencies refers to individual particularities of sepsis-related multiorgan failure. Finally, the patient’s trajectory in the ICU points out the need of a better understanding of interindividual response to various supportive therapies. This review aims to identify the main sources of variability in clustering septic patients in various clinical phenotypes, as a useful clinical tool for precision-based approach in sepsis and septic shock.

Keywords

sepsis; septic shock; omics; phenotype; precision medicine; multiorgan disfunction; personalized therapy

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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