A special article published in the August 2020 issue of Critical Care Medicine by members of the Surviving Sepsis Campaign Research Committee.
The Sepsis-3 Task Force, jointly sponsored by the Society of Critical Care Medicine (SCCM) and The European Society of Intensive Care Medicine (ESICM), recently redefined sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. One objective underlying this new definition was to refocus basic research into the pathobiology of this deadly syndrome. Specifically, the Task Force members sought to: 1) emphasize that organ dysfunction is a key, defining characteristic of sepsis; 2) broaden the scope of investigation to include aspects of the host response beyond immunologic changes; and 3) direct studies toward identifying the links between the host response to infection and the development of organ dysfunction. The papers that resulted from the work of the Task Force have generated both enthusiasm and controversy. Most of the response, however, has focused not on the redefinition but rather on the evidence-based clinical criteria used by the Task Force to identify patients with sepsis from patients with uncomplicated infection. The definition is inherently difficult to examine in the clinical arena because clinical identifiers of “organ dysfunction” and “dysregulated host response” are limited. Therefore, the Task Force explicitly stressed that future research into the basic science of sepsis focus on clinically applicable identifiers of “organ dysfunction” and “dysregulated host response.”
A second major collaboration between the SCCM and the ESICM is the Surviving Sepsis Campaign (SSC). In formalizing their joint responsibilities for the SSC, the leaders of both societies established a Research Committee. The first task of the committee was to identify future research priorities. The deliberations of the committee led to the joint publication of “Surviving Sepsis Campaign Research Priorities for Sepsis and Septic Shock” in the journals Critical Care Medicine and Intensive Care Medicine in August 2018. The initial document presented a broad overview of research priorities in several critical care domains with an expressed intention to, in the future, publish separate papers with more detailed descriptions for each domain. This paper, focusing on basic/translational science, contains the effort to fulfill that promise.
Clifford S. Deutschman, MD
Judith Hellman, MD
Ricard Ferrer Roca, MD
Daniel De Backer, MD
Craig M. Coopersmith, MD