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Biomarkers in sepsis-looking for the Holy Grail or chasing a mirage!

查看全文 作  者:Neelmani [1]Ahuja;Anjali [1]Mishra;Ruchi [1]Gupta;Sumit [1]Ray 高影响力作者 机构地区:[1]Department of Critical Care Medicine,Holy Family Hospital,Delhi 110025,India高影响力机构 出  处:《World Journal of Critical Care Medicine》索引2023年第12卷第4期,共16页高影响力期刊 摘  要:Sepsis is defined as a life-threatening organ dysfunction caused by the dysregulated host response to infection.It is a complex syndrome and is characterized by physiologic,pathologic and biochemical abnormalities in response to an infection.Diagnosis of sepsis is based on history,physical examination and other investigations(including biomarkers)which may help to increase the certainty of diagnosis.Biomarkers have been evaluated in the past for many diseases and have been evaluated for sepsis as well.Biomarkers may find a possible role in diagnosis,prognostication,therapeutic monitoring and anti-microbial stewardship in sepsis.Since the pathophysiology of sepsis is quite complex and is incompletely understood,a single biomarker that may be robust enough to provide all information has not been found as of yet.However,many biomarkers have been studied and some of them have applications at the bedside and guide clinical decision-making.We evaluated the PubMed database to search for sepsis biomarkers for diagnosis,prognosis and possible role in antibiotic escalation and de-escalation.Clinical trials,meta-analyses,systematic reviews and randomized controlled trials were included.Commonly studied biomarkers such as procalcitonin,Soluble urokinase-type plasminogen activator(Supar),presepsin,soluble triggering receptor expressed on myeloid cells 1,interleukin 6,C-reactive protein,etc.,have been described for their possible applications as biomarkers in septic patients.The sepsis biomarkers are still an area of active research with newer evidence adding to the knowledge base continuously.For patients presenting with sepsis,early diagnosis and prompt resuscitation and early administration of anti-microbials(preferably within 1 h)and source control are desired goals.Biomarkers may help us in the diagnosis,prognosis and therapeutic monitoring of septic patients.The marker redefining our view on sepsis is yet a mirage that clinicians and researchers continue to chase. 关 键 词:SEPSIS Sepsis biomarkers PROCALCITONIN Presepsin OMICS
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