Sepsis: Something old, something new, and a systems view.
PMID 21798705 · Journal of critical care · 2012 · DOI 10.1016/j.jcrc.2011.05.025
Authors: Rami Namas; Ruben Zamora; Rajaie Namas; Gary An; John Doyle; Thomas E Dick; Frank J Jacono; Ioannis P Androulakis; Gary F Nieman; Steve Chang; Timothy R Billiar; John A Kellum; Derek C Angus; Yoram Vodovotz
Abstract
Sepsis is a clinical syndrome characterized by a multisystem response to a microbial pathogenic insult consisting of a mosaic of interconnected biochemical, cellular, and organ-organ interaction networks. A central thread that connects these responses is inflammation that, while attempting to defend the body and prevent further harm, causes further damage through the feed-forward, proinflammatory effects of damage-associated molecular pattern molecules. In this review, we address the epidemiology and current definitions of sepsis and focus specifically on the biologic cascades that comprise the inflammatory response to sepsis. We suggest that attempts to improve clinical outcomes by targeting specific components of this network have been unsuccessful due to the lack of an integrative, predictive, and individualized systems-based approach to define the time-varying, multidimensional state of the patient. We highlight the translational impact of computational modeling and other complex systems approaches as applied to sepsis, including in silico clinical trials, patient-specific models, and complexity-based assessments of physiology.
Humans; Inflammation; Models, Biological; Nonlinear Dynamics; Sepsis; Systems Biology
Cite
Rami Namas; Ruben Zamora; Rajaie Namas; Gary An; John Doyle; Thomas E Dick; Frank J Jacono; Ioannis P Androulakis; Gary F Nieman; Steve Chang; Timothy R Billiar; John A Kellum; Derek C Angus; Yoram Vodovotz. Sepsis: Something old, something new, and a systems view. Journal of critical care (2012). PMID 21798705. DOI 10.1016/j.jcrc.2011.05.025.