Repository logo
 

How to use biomarkers of infection or sepsis at the bedside: guide to clinicians.

Accepted version
Peer-reviewed

Type

Article

Change log

Abstract

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. In this context, biomarkers could be considered as indicators of either infection or dysregulated host response or response to treatment and/or aid clinicians to prognosticate patient risk. More than 250 biomarkers have been identified and evaluated over the last few decades, but no biomarker accurately differentiates between sepsis and sepsis-like syndrome. Published data support the use of biomarkers for pathogen identification, clinical diagnosis, and optimization of antibiotic treatment. In this narrative review, we highlight how clinicians could improve the use of pathogen-specific and of the most used host-response biomarkers, procalcitonin and C-reactive protein, to improve the clinical care of patients with sepsis. Biomarker kinetics are more useful than single values in predicting sepsis, when making the diagnosis and assessing the response to antibiotic therapy. Finally, integrated biomarker-guided algorithms may hold promise to improve both the diagnosis and prognosis of sepsis. Herein, we provide current data on the clinical utility of pathogen-specific and host-response biomarkers, offer guidance on how to optimize their use, and propose the needs for future research.

Description

Keywords

Journal Title

Intensive Care Med

Conference Name

Journal ISSN

0342-4642
1432-1238

Volume Title

Publisher

Springer Science and Business Media LLC
Sponsorship
MRC (MR/V006118/1)
ACM is is supported by a Clinician Scientist Fellowship from the Medical Research Council (MR/V006118/1)