title: Understanding the PIRO concept: from theory to clinical practice - part 2.
abstract: A sepsis staging system focused on predisposition, insult, host response and organ failure may provide a useful basis for risk stratification. Knowledge on interactions among predisposing factors, insult characteristics and host response might help us to improve our understanding on sepsis pathophysiology and allow more individual therapeutic approach. Recent clinical studies documented the clinical importance of PIRO approach for severity stratification in septic patients in intensive care unit, and also for specific conditions such as community acquired pneumonia and ventilator associated pneumonia , with a good performance for outcome prediction. In this review we describe how this new concept can be used in clinical practice and provide some insights on its usefulness to facilitate the stratification and potential for enrollment in clinical trials of sepsis therapies.
authors.affiliation: Centro de Terapia Intensiva, Hospital do Câncer-I, Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Maira de Moraes
authors.initials: Mde M
authors.lastname: Rosolem
authors.affiliation: Centro de Terapia Intensiva, Hospital do Câncer-I, Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Lígia Sarmet Cunha Farah
authors.initials: LS
authors.lastname: Rabello
authors.affiliation: Centro de Pesquisa, Hospital do Câncer-I, Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Juliana Vassalo
authors.initials: JV
authors.lastname: Leal
authors.affiliation: Centro de Terapia Intensiva, Hospital do Câncer-I, Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Márcio
authors.initials: M
authors.lastname: Soares
authors.affiliation: Centro de Terapia Intensiva, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - UFRS, Porto Alegre, RS, Brasil.
authors.forename: Thiago
authors.initials: T
authors.lastname: Lisboa
authors.affiliation: Centro de Terapia Intensiva, Hospital de Câncer-I, Instituto Nacional de Câncer - INCA, Rio de Janeiro, RJ, Brasil.
authors.forename: Jorge Ibrain Figueira
authors.initials: JI
authors.lastname: Salluh