Future of the ICU: finding treatable needles in the data haystack

Excerpt

The identification of subtypes of disease with distinct clinical and biological features, divergent natural histories, and differential treatment responses has had a major impact on a variety of medical domains, ranging from oncology to infectious diseases. Nowadays, sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1]. In this focus editorial we break down the need for an individualization of treatment into three axes: the infection (i.e., the pathogen), the host response and organ dysfunction (Fig. 1). The key message is that patients fulfilling the sepsis criteria are very dissimilar and that this heterogeneity results in non-superiority for almost every tested intervention. In the ICU of the future, sepsis will be classified based on treatable traits in these three dimensions. The biggest challenge of the coming decade is to make sense of huge datasets and to integrate epidemiological and biological data into a single perspective. …