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Trends and Prospects in Sepsis and Septic Shock
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Trends and Prospects in Sepsis and Septic Shock

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 5420

Special Issue Editor

Dr. Changhong Miao

E-Mail Website
Guest Editor
1. Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
2. Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
3. Shanghai Key Laboratory of Perioperative Stress and Protection, Shanghai, China
Interests: sepsis; sepsis lung injury; neutrophil; neutrophil extracellular traps; PICS

Special Issue Information

Dear Colleagues,

Sepsis, a life-threatening syndrome characterized by organ failure after infection, is the most common cause of death in hospitalized patients. Sepsis treatment is generally supportive in nature, involving the administration of intravenous fluids, vasoactive substances, and antibiotics to eliminate the pathogen. No drugs have been explicitly approved for sepsis treatment, and clinical trials of potential therapies have failed, suggesting that new approaches are needed. COVID-19-induced sepsis is a classic example. Therefore, it is crucial to find a new strategy to further investigate the pathogenesis and pathophysiological process for sepsis treatment and new drugs.

In this Special Issue, we welcome original research articles, reviews, opinion, perspective, and systematic reviews, including but not limited to the following themes:

  • Investigation of the pathophysiological mechanism and new targets of sepsis: investigation of the pathophysiological mechanism and signal transduction pathway of sepsis, and discovery of new potential drug targets.
  • New drug studies for sepsis: based on new drug studies for sepsis, such as studies of artemisinin and its derivatives to intervene in sepsis immune disorders, and drug studies for NETs.
  • Investigation of other treatments against sepsis: investigation of new hemodialyzers to remove endotoxins and excess pro-inflammatory cytokines in the blood, the use of anti-infective drugs to stop the proliferation of pathogens (bacteria and viruses) during sepsis, and the development of new anti-infection agents.

Dr. Changhong Miao
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sepsis
  • sepsis organ injury
  • immunosuppression
  • neutrophil
  • neutrophil extracellular traps
  • PICS

Published Papers (3 papers)

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Research

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22 pages, 7584 KiB  
Article
Neutrophil Extracellular Traps Upregulate p21 and Suppress Cell Cycle Progression to Impair Endothelial Regeneration after Inflammatory Lung Injury
by Shuainan Zhu, Ying Yu, Qianya Hong, Chenning Li, Hao Zhang and Kefang Guo
J. Clin. Med. 2024, 13(5), 1204; https://doi.org/10.3390/jcm13051204 - 20 Feb 2024
Viewed by 746
Abstract
Background: Sepsis is a major cause of ICU admissions, with high mortality and morbidity. The lungs are particularly vulnerable to infection and injury, and restoration of vascular endothelial homeostasis after injury is a crucial determinant of outcome. Neutrophil extracellular trap (NET) release strongly [...] Read more.
Background: Sepsis is a major cause of ICU admissions, with high mortality and morbidity. The lungs are particularly vulnerable to infection and injury, and restoration of vascular endothelial homeostasis after injury is a crucial determinant of outcome. Neutrophil extracellular trap (NET) release strongly correlates with the severity of lung tissue damage. However, little is known about whether NETs affect endothelial cell (EC) regeneration and repair. Methods: Eight- to ten-week-old male C57BL/6 mice were injected intraperitoneally with a sublethal dose of LPS to induce acute lung inflammatory injury or with PBS as a control. Blood samples and lung tissues were collected to detect NET formation and lung endothelial cell proliferation. Human umbilical vein endothelial cells (HUVECs) were used to determine the role of NETs in cell cycle progression in vitro. Results: Increased NET formation and impaired endothelial cell proliferation were observed in mice with inflammatory lung injury following septic endotoxemia. Degradation of NETs with DNase I attenuated lung inflammation and facilitated endothelial regeneration. Mechanistically, NETs induced p21 upregulation and cell cycle stasis to impair endothelial repair. Conclusions: Our findings suggest that NET formation impairs endothelial regeneration and vascular repair through the induction of p21 and cell cycle arrest during inflammatory lung injury. Full article
(This article belongs to the Special Issue Trends and Prospects in Sepsis and Septic Shock)
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12 pages, 1590 KiB  
Article
Does Prehospital Suspicion of Sepsis Shorten Time to Administration of Antibiotics in the Emergency Department? A Retrospective Study in One University Hospital
by Matthias Bollinger, Nadja Frère, Alexander Daniel Shapeton, Weronika Schary, Matthias Kohl, Clemens Kill and Joachim Riße
J. Clin. Med. 2023, 12(17), 5639; https://doi.org/10.3390/jcm12175639 - 30 Aug 2023
Cited by 1 | Viewed by 1193
Abstract
Early treatment is the mainstay of sepsis therapy. We suspected that early recognition of sepsis by prehospital healthcare providers may shorten the time for antibiotic administration in the emergency department. We retrospectively evaluated all patients above 18 years of age who were diagnosed [...] Read more.
Early treatment is the mainstay of sepsis therapy. We suspected that early recognition of sepsis by prehospital healthcare providers may shorten the time for antibiotic administration in the emergency department. We retrospectively evaluated all patients above 18 years of age who were diagnosed with sepsis or severe infection in our emergency department between 2018 and 2020. We recorded the suspected diagnosis at the time of presentation, the type of referring healthcare provider, and the time until initiation of antibiotic treatment. Differences between groups were calculated using the Kruskal–Wallis rank sum test. Of the 277 patients who were diagnosed with severe infection or sepsis in the emergency department, an infection was suspected in 124 (44.8%) patients, and sepsis was suspected in 31 (11.2%) patients by referring healthcare providers. Time to initiation of antibiotic treatment was shorter in patients where sepsis or infection had been suspected prior to arrival for both patients with severe infections (p = 0.022) and sepsis (p = 0.004). Given the well-described outcome benefits of early sepsis therapy, recognition of sepsis needs to be improved. Appropriate scores should be used as part of routine patient assessment to reduce the time to antibiotic administration and improve patient outcomes. Full article
(This article belongs to the Special Issue Trends and Prospects in Sepsis and Septic Shock)
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Other

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29 pages, 2115 KiB  
Systematic Review
Machine Learning-Based Early Prediction of Sepsis Using Electronic Health Records: A Systematic Review
by Khandaker Reajul Islam, Johayra Prithula, Jaya Kumar, Toh Leong Tan, Mamun Bin Ibne Reaz, Md. Shaheenur Islam Sumon and Muhammad E. H. Chowdhury
J. Clin. Med. 2023, 12(17), 5658; https://doi.org/10.3390/jcm12175658 - 30 Aug 2023
Cited by 3 | Viewed by 3030
Abstract
Background: Sepsis, a life-threatening infection-induced inflammatory condition, has significant global health impacts. Timely detection is crucial for improving patient outcomes as sepsis can rapidly progress to severe forms. The application of machine learning (ML) and deep learning (DL) to predict sepsis using electronic [...] Read more.
Background: Sepsis, a life-threatening infection-induced inflammatory condition, has significant global health impacts. Timely detection is crucial for improving patient outcomes as sepsis can rapidly progress to severe forms. The application of machine learning (ML) and deep learning (DL) to predict sepsis using electronic health records (EHRs) has gained considerable attention for timely intervention. Methods: PubMed, IEEE Xplore, Google Scholar, and Scopus were searched for relevant studies. All studies that used ML/DL to detect or early-predict the onset of sepsis in the adult population using EHRs were considered. Data were extracted and analyzed from all studies that met the criteria and were also evaluated for their quality. Results: This systematic review examined 1942 articles, selecting 42 studies while adhering to strict criteria. The chosen studies were predominantly retrospective (n = 38) and spanned diverse geographic settings, with a focus on the United States. Different datasets, sepsis definitions, and prevalence rates were employed, necessitating data augmentation. Heterogeneous parameter utilization, diverse model distribution, and varying quality assessments were observed. Longitudinal data enabled early sepsis prediction, and quality criteria fulfillment varied, with inconsistent funding–article quality correlation. Conclusions: This systematic review underscores the significance of ML/DL methods for sepsis detection and early prediction through EHR data. Full article
(This article belongs to the Special Issue Trends and Prospects in Sepsis and Septic Shock)
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