Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119228, Singapore.
Cells. 2023 Feb 8;12(4):541. doi: 10.3390/cells12040541.
Current guidelines for critically ill patients use broad recommendations to promote uniform protocols for the management of conditions such as acute kidney injury, acute respiratory distress syndrome, and sepsis. Although these guidelines have enabled the substantial improvement of care, mortality for critical illness remains high. Further outcome improvement may require personalizing care for critically ill patients, which involves tailoring management strategies for different patients. However, the current understanding of disease heterogeneity is limited. For critically ill patients, genomics, transcriptomics, proteomics, and metabolomics have illuminated such heterogeneity and unveiled novel biomarkers, giving clinicians new means of diagnosis, prognosis, and monitoring. With further engineering and economic development, omics would then be more accessible and affordable for frontline clinicians. As the knowledge of pathophysiological pathways mature, targeted treatments can then be developed, validated, replicated, and translated into clinical practice.
目前,危重症患者的治疗指南采用广泛的建议来促进急性肾损伤、急性呼吸窘迫综合征和脓毒症等疾病管理的统一方案。尽管这些指南使护理水平得到了显著提高,但危重症患者的死亡率仍然很高。要进一步提高预后,可能需要对危重症患者进行个体化治疗,这涉及为不同患者定制管理策略。然而,目前对疾病异质性的认识有限。对于危重症患者来说,基因组学、转录组学、蛋白质组学和代谢组学揭示了这种异质性,并发现了新的生物标志物,为临床医生提供了新的诊断、预后和监测手段。随着工程和经济的进一步发展,组学将更容易为一线临床医生所接受和负担得起。随着病理生理途径知识的成熟,然后可以开发、验证、复制并将靶向治疗转化为临床实践。