Precision Medicine in the Intensive Care Unit

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Critical Care".

Deadline for manuscript submissions: closed (10 May 2025) | Viewed by 1761

Special Issue Editors


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Guest Editor
Department of Anesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: intensive care; major burns; anesthesiology

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Interests: intensive care; extracorporeal support; liver failure; shock

Special Issue Information

Dear Colleagues,

In the last decade, we have made a significant change in the way we treat critically ill patients. The medical scene has shifted into a new era of personalized medicine in which we diagnose, monitor, and treat our patients based not on predefined universal criteria but on an individual basis, looking at specific phenotypes. We now know that the classic “one size fits all” approach is no longer accurate, and critically illnesses are very heterogenous. In this way, the care we provide to our patients has significantly improved and is now focused not on classical syndromes, like ARDS and sepsis, but on advanced diagnostics and the specific molecular mechanisms of disease, and our management aims to rebalance the body’s specific homeostasis. This Special Issue, “Precision Medicine in the Intensive Care Unit”, will address current state-of-the art research on challenges and advances in the field of critical care. We encourage the submission of reviews and original articles that address clinical advances in the development of patient-centered management of the critically ill patient.

Dr. Carmen Orban
Dr. Mihai Popescu
Guest Editors

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Keywords

  • critical care
  • phenotypes in the intensive care unit
  • personalized medicine
  • patient-centered management
  • organ dysfunction
  • organ support
  • advanced monitoring
  • diagnostics

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Published Papers (1 paper)

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Research

16 pages, 1837 KiB  
Article
Hemogram-Based Phenotypes of the Immune Response and Coagulopathy in Blunt Thoracic Trauma
by Alexandru Emil Băetu, Liliana Elena Mirea, Cristian Cobilinschi, Ioana Cristina Grințescu and Ioana Marina Grințescu
J. Pers. Med. 2024, 14(12), 1168; https://doi.org/10.3390/jpm14121168 - 21 Dec 2024
Viewed by 961
Abstract
Background: Blunt thoracic trauma possesses unique physiopathological traits due to the complex interaction of immune and coagulation systems in the lung tissue. Hemogram-based ratios such as neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte × platelet (NLPR) ratios have been studied as proxies for immune [...] Read more.
Background: Blunt thoracic trauma possesses unique physiopathological traits due to the complex interaction of immune and coagulation systems in the lung tissue. Hemogram-based ratios such as neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte × platelet (NLPR) ratios have been studied as proxies for immune dysregulation and survival in trauma. We hypothesized that blunt thoracic trauma patients exhibit distinct patterns of coagulation and inflammation abnormalities identifiable by the use of readily available hemogram-derived markers. Methods: The present study represents a retrospective observational analysis that included 86 patients with blunt thoracic trauma from a single high-volume level one trauma center. The primary outcome was mortality prediction in blunt thoracic trauma patients using these derived biomarkers. Secondary outcomes included phenotypes of the immune response and coagulopathy and the prediction of non-fatal adverse events. Results: A U-shaped distribution of mortality was found, with high rates of early deaths in patients with an NLPR value of <3.1 and high rates of late deaths in patients with NLPR > 9.5. A subgroup of blunt thoracic trauma patients expressing moderate inflammation and inflammation-induced hypercoagulation objectified as NLPR between 3.1 and 9.5 may have a survival benefit (p < 0.0001). The NLPR cut-off for predicting early deaths and the need for massive transfusion was 3.1 (sensitivity = 80.00% and specificity = 71.05%). Conclusions: These findings suggest that blunt thoracic trauma patients exhibit distinct phenotypes of the immune response and coagulopathy from the early stages. A controlled, balanced interaction of immune, coagulation, and fibrinolytic systems might effectively achieve tissue repair and increase survival in thoracic trauma patients and should be subject to further research. Full article
(This article belongs to the Special Issue Precision Medicine in the Intensive Care Unit)
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