Redefining critical illness.
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Authors
Maslove, David M
Tang, Benjamin
Shankar-Hari, Manu
Lawler, Patrick R
Angus, Derek C
Baillie, J Kenneth
Baron, Rebecca M
Bauer, Michael
Buchman, Timothy G
Calfee, Carolyn S
dos Santos, Claudia C
Giamarellos-Bourboulis, Evangelos J
Gordon, Anthony
Kellum, John A
Knight, Julian C
Leligdowica, Aleksandra
McAuley, Daniel F
McLean, Anthony S
Menon, David K
Meyer, Nuala J
Moldawer, Lyle L
Reddy, Kiran
Reilly, John P
Russell, James
Sevransky, Jonathan E
Seymour, Christopher W
Shapiro, Nathan I
Singer, Mervyn
Sweeney, Timothy E
Thompson, B Taylor
van der Poll, Tom
Venkatesh, Bala
Walley, Keith R
Walsh, Timothy S
Ware, Lorraine B
Wong, Hector R
Zsolt, Zador E
Marshall, John C
Journal Title
Nature Medicine
ISSN
1078-8956
Publisher
Nature Research
Type
Article
This Version
AM
Metadata
Show full item recordCitation
Maslove, D. M., Tang, B., Shankar-Hari, M., Lawler, P. R., Angus, D. C., Baillie, J. K., Baron, R. M., et al. Redefining critical illness.. Nature Medicine https://doi.org/10.17863/CAM.83428
Abstract
Both research and practice in critical care medicine have long been defined by syndromes. Though clinically recognizable entities, these are in fact loose amalgams of heterogeneous states, within which responses to therapy may vary. Mounting translational evidence suggests the current syndrome-based framework of critical illness should be reconsidered. Moreover, research conducted during the COVID-19 pandemic illustrates how the study of a more biologically homogeneous condition – respiratory failure due to SARS-CoV-
2 infection – can increase the efficiency with which actionable results are generated. We discuss recent findings from basic science and clinical research in critical care, and explore how these might inform a new conceptual model of critical illness. De-emphasizing syndromes,
we focus instead on the underlying biological changes that underpin critical illness states, and that may be amenable to treatment. We hypothesize that such an approach will accelerate translational critical care research, leading to a richer understanding of the pathobiology of
critical illness and of the proximate determinants of ICU outcomes. The specificity and granularity gained will support the design of more effective clinical trials, and inform a more precise, effective practice at the bedside.
Embargo Lift Date
2025-04-11
Identifiers
This record's DOI: https://doi.org/10.17863/CAM.83428
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335996
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