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Researchers help redefine sepsis and its early diagnosis

NurseDr Manu Shankar-Hari from the Division of Asthma, Allergy & Lung Biology has been involved in an international effort to redefine sepsis and septic shock along with a method to identify at risk patients with suspected infection, allowing for more timely management of the condition. This update replaces the previous definitions of this syndrome, first proposed in 1992 and re-defined 15 years ago in 2001. 

The three studies for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were published in the Journal of the American Medical Association (JAMA) and is the first time that the journal has published an entire edition of with papers from critical care medicine. The Society of Critical Care Medicine and The European Society of Intensive Care Medicine funded this international collaborative work. The International Sepsis Task Force comprised of 19 scientists from across the globe consisting of clinicians, basic scientists, clinical trialists and health service researchers.

Dr Manu Shankar-Hari is the Lead author for one of the three papers: Developing a New Definition and Assessing New Clinical Criteria for Septic Shock (Sepsis-3). He said of the study

‘Septic shock is a complex illness. The previous Consensus Definitions (1991 and 2001) place emphasis on the circulatory abnormalities as the core concept and neither definitions provide data driven clinical criteria. In addition, the last ten years of basic science research has established the concept that septic shock is associated with plethora of cellular and metabolic abnormalities (often referred to as cellular stress), alongside circulatory dysfunction.

In this background, the paper published in JAMA provides an updated illness concept (definitions) and data driven clinical criteria for diagnosing septic shock at the bedside. Our message is septic shock the most severe form of sepsis and carries a high mortality. The proposed definition and clinical criteria provide a framework to harmonise what we label as septic shock internationally.’

Although the new definition is another step towards gaining further understanding of sepsis, the studies themselves acknowledge the condition is not completely understood and there is an urgent need for focused research into this potentially fatal illness.

The three studies are available on the JAMA website:

An interview with Dr Shankar-Hari is available on ESICM website.

Further details are available from SCCM website.

Read more about Dr Shankar-Hari's research interests on the King's College London and the Guy’s and St Thomas’ NHS Foundation Trust websites.