ReviewJournal of biomedical science2024
Revolution in sepsis: a symptoms-based to a systems-based approach?
Review in Journal of biomedical science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mitochondrial dysfunction in sepsis: nutritional strategies for restoring bioenergetic homeostasis.Frontiers in cellular and infection microbiology · 2026Pooled it
- The core role of central nervous system in sepsis-related organ damage.Frontiers in immunology · 2025Pooled it
- Associations of Heart Rate Trajectories with Mortality and AKI Occurrence in Septic Patients: A Retrospective Study from MIMIC-IV and eICU Databases.Journal of clinical medicine · 2026Article
- Application of a machine learning model integrating T cell subsets and clinical markers in 28-Day mortality prediction of sepsis patients.Clinical and experimental medicine · 2026Article
- Moxibustion combined with anti-PD-1 antibodies improves immunosuppression in septic mice potentially through the PD-1/PD-L1 pathway.Immunologic research · 2026Article
- Modulating Vimentin: A Systems-Level Therapeutic Strategy for Sepsis and Complex Diseases.Life (Basel, Switzerland) · 2026Article
- Endothelial cell injury: a crucial link in microcirculatory dysfunction associated with sepsis.World journal of emergency medicine · 2026Review
- Mechanism of sepsis regulation by ELANE via macrophage polarization.Scientific reports · 2025Article
- Sepsis-Induced Coagulopathy and Hypoalbuminemia: Endothelial Damage as Common Pathway and Clinical Implications on Mortality and Transfusion Risk.Journal of clinical medicine · 2025Article
- Acute Kidney Injury During Sepsis and Prognostic Role of Coexistent Chronic Heart Failure.Journal of clinical medicine · 2025Review
- Machine Learning-Based Mortality Risk Prediction Model in Patients with Sepsis.Journal of inflammation research · 2025Article
- Effects of Shenfu injection on intestinal microbiota and inflammation in sepsis mice.Frontiers in cellular and infection microbiology · 2025Article
- Regulation of ubiquitination in sepsis: from PAMP versus DAMP to peripheral inflammation and cell death.Frontiers in immunology · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Severe infection and sepsis are medical emergencies. High morbidity and mortality are linked to CNS dysfunction, excessive inflammation, immune compromise, coagulopathy and multiple organ dysfunction. Males appear to have a higher risk of mortality than females. Currently, there are few or no effective drug therapies to protect the brain, maintain the blood brain barrier, resolve excessive inflammation and reduce secondary injury in other vital organs. We propose a major reason for lack of progress is a consequence of the treat-as-you-go, single-nodal target approach, rather than a more integrated, systems-based approach. A new revolution is required to better understand how the body responds to an infection, identify new markers to detect its progression and discover new system-acting drugs to treat it. In this review, we present a brief history of sepsis followed by its pathophysiology from a systems' perspective and future opportunities. We argue that targeting the body's early immune-driven CNS-response may improve patient outcomes. If the barrage of PAMPs and DAMPs can be reduced early, we propose the multiple CNS-organ circuits (or axes) will be preserved and secondary injury will be reduced. We have been developing a systems-based, small-volume, fluid therapy comprising adenosine, lidocaine and magnesium (ALM) to treat sepsis and endotoxemia. Our early studies indicate that ALM therapy shifts the CNS from sympathetic to parasympathetic dominance, maintains cardiovascular-endothelial glycocalyx coupling, reduces inflammation, corrects coagulopathy, and maintains tissue O
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.