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Critical care mostly implies life-threatening situations involving systemic infection, inflammation and necrosis. Biofluids are an easily accessible source of liquid biopsies that can be used to monitor the evolution of the patient’s critical illness. The cellular and molecular profiling of necrosis and inflammation in biofluids using cutting-edge technologies such as realtime immunodiagnostics, next-generation sequencing and mass spectrometry will pave the way for precision medicine v2.0 in critical care. This is needed for data mining approaches to allow patientclustering, identify novel biomarkers and develop novel intervention strategies controlling necrosis and inflammation. The real-time monitoring of biomarkers will allow continued (re)evaluation of treatment strategies using machine learning models.
The graphical abstract depicts the development of blood cell lineages under conditions of homeostasis (top, left), acute inflammation (top, right), chronic inflammation (bottom, left) or hematological malignancy (bottom, right). Arrow strength indicates preferential differentation of hematopoeitic stem cells (HSC) or their malignant counterparts (LSC; leukemic stem cells) into different mature blood cell lineages. Scattered arrows indicate no/low cellular output along the respective cellular lineage. Homeostasis and acute inflammation can develop into a condition of chronic inflammation during ageing or situations of chronic disease as indicates by the arrows. Niche dysfunction and cellular stress during chronic inflammation favour the development of hematological malignancy. HSC: hematopoietic stem cell; LSC: leukemic stem cell; Meg: megakaryocytes; E: Erythrocytes; ROS: reactive oxygen species.