Sepsis
Affiliations & Notes
aBloomsbury Intensive Care Medicine Institute, Centre for Respiratory Medicine, University College London, London, UK
bCenter for Clinical Research, Investigation, and Systems Modeling of Acute Illness, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
cIHU PROMETHEUS, Comprehensive Sepsis Centre, General Intensive Care Unit, Raymond Poincaré Hospital, Garches, France
dSchool of Medicine Simone Veil, University of Versailles Saint-Quentin-en-Yvelines, Paris, France
eDepartment of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
fDivision of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
gDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute, Boston, MA, USA
hDepartment of Medicine, Brigham and Women's Hospital, Boston, MA, USA
iEscola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
jDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
kGrady Memorial Hospital, Atlanta, GA, USA
lDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA
mDepartment of Anesthesiology, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
nCentre for Critical Illness Research, King's College London, London, UK
oDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
pClinical Division, and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
Article Info
Publication History:
Published February 26, 2026
DOI: 10.1016/S0140-6736(25)02422-5 External LinkAlso available on ScienceDirect External Link
Copyright: © 2025 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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Figures (7)
Article metrics
Metric data currently unavailableFigure 1 Organ dysfunctions in sepsis
Created in BioRender. Singer, M (2025) https://BioRender.com/l1o1l55. ARDS=acute respiratory distress syndrome.
Figure 2 Risk factors for infection and progression to sepsis
ICU=intensive care unit. CMV=cytomegalovirus.
Figure 3 Reframing conceptual fundamentals underlying immune and non-immune responses
DAMPs=damage-associated molecular patterns. cfDNA=cell-free DNA. mtDNA=mitochondrial DNA. HSP=heat shock protein. LPS=lipopolysaccharide. NLR=nucleotide-binding oligomerisation domain-like receptor. PAMPs=pathogen-associated molecular patterns. PRRs=pathogen recognition receptors. ROS=reactive oxygen species. TLR=toll-like receptor.
Figure 4 Schematic of sepsis pathophysiology, highlighting substantial crosstalk
Created in BioRender. Singer, M (2025) https://BioRender.com/n99wt2j. DAMPs=damage-associated molecular patterns. PAMPs=pathogen-associated molecular patterns.
Figure 5 Sepsis management summary
Created in BioRender. Singer, M (2025) https://BioRender.com/dx0h1z2.
Figure 6 Timing of antibiotic initiation and illness severity
Created in BioRender. Singer, M (2025) https://BioRender.com/y9ci3ya. NEWS2=National Early Warning Score-2.
Figure 7 Patient-centred versus pragmatic outcomes
Created in BioRender. Singer, M (2025) https://BioRender.com/a1y8jmc.
