Immune Metabolism in Sepsis, Inflammation & Liver Failure-iMET
The iMET study examines the immunobiology of sepsis, inflammation and liver failure.
INCLUSION CRITERIA
Main disease group inclusion criteria for analysis of blood, urine and exhaled breath
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Patients with sepsis or suspected sepsis
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Patients with acute hepatic failure or chronic liver disease
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Main disease group inclusion criteria for analysis of blood and urine (where the viral content of exhaled breath may be pathological)
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Patients with confirmed or suspected COVID19 infection requiring admission to hospital or critical care.
EXCLUSION CRITERIA
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Age<16
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Evidence of disseminated malignancy (isolated hepatocellular carcinoma without evidence of secondary spread is NOT an exclusion criteria).
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Pre-existing immunosuppressive states including HIV infection and chronic granulomatous diseases.
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Immunosuppression other than low dose steroids (>40mg prednisolone or equivalent)
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Pregnancy
Study Information
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Sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection
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Organ dysfunction: an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more (assume a baseline of 0 if no baseline available), OR
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qSOFA>1 of respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100mmHg or less (SEPSIS 3 and quick SOFA)
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Liver disease: Acute liver failure (coagulopathy-INR>1.5); jaundice (bilirubin>30umol/l) and any hepatic encephalopathy with previous normal liver function; Chronic liver disease (cirrhosis by clinical, biochemical, radiological or histological criteria, subdivided into 1. Stable cirrhosis (SC); 2. Acute decompensation (AD); 3. Acute on chronic liver failure (ACLF)
