Vall d'Hebron Talks by VHIR 'Revisiting the old paradigms in Sepsis: from "phases" to "patients"

Speaker:  Prof. Jesús Francisco Bermejo Martín. MD PhD Professor (PPL), Medicine Dept, Universidad de Salamanca (USAL). Principal Investigator, BioSepsis (Translational Research in Severe Infections) - IBSAL / USAL / CIBERES / EGIS.

Classical perspectives approaching the understanding of sepsis physiopathogenesis propose over-simplified models depicting the existence of “phases” (inflammatory / immunosuppression) occurring in either a sequential or a simultaneous manner. These “one-size-fits-all” models do not capture the complexity of sepsis, which is characterised by a large variety of clinical presentations, responding probably to different biological events in each individual patient. In our view, the “original sin” of sepsis is the inability of the host to control the pathogen using balanced responses which prevent damage to the tissues. Our hypothesis is that, when first contacting the health care system, some sepsis patients show unremitting pathogen replication, while others have already controlled the pathogen but at the cost of ongoing tissue damage perpetuating organ failure. For sure, the basal immunocompetence status of the patient has much to do with how sepsis will present and develop either from the biological and the clinical side. This talk will propose thus a new provocative perspective on how sepsis pathogenesis should be approached, a new perspective that overcomes the “phases models” to move to a more personalised model considering together microbial and host parameters to define the true individual biological status of each case of sepsis. This new model should be taken into account to improve treatment success in this severe condition. 

Host: Dr. Juan Carlos Ruiz, Shock, Organ Dysfunction and Resuscitation.