The Use of Biomarkers in the Diagnosis and Management of Sepsis
Janice Conway-Klaassen, Patricia Tille, Hassan Aziz
Int. J. Bio. Lab. Sci 2020 1:23-31 【Abstract】 【PDF】
Rapid diagnosis of patients with sepsis or septic shock is critical to improve care and reduce morbidity and mortality. Traditional diagnostic methods such as blood cultures and complete blood count analyses are non-specific and do not always correlate with the patient condition. In addition, blood cultures may not be positive even in confirmed cases of sepsis and may take 48 hours or longer for confirmation. Alternative diagnostic methods such as biomarkers, have been investigated for their possible value in prediction, diagnosis, and management of patients with sepsis. Biomarkers are compounds associated with a particular condition, organ, or disease state. An ideal biomarker should confirm or predict that a patient has sepsis or is at high risk for sepsis. To be effective, these biomarkers must provide high sensitivity and specificity as well as allow testing by methods that are readily available and allow rapid turn-around of results. This study reviews the potential of several biomarkers that are part of the inflammatory reaction during infection and sepsis and those involved in the patients immunologic response to infection. Many of the biomarkers associated with the inflammatory response are non-specific for diagnosis of sepsis but may have a role in monitoring the patients response to therapy. Immune response related biomarkers may help rule-in or rule-out sepsis in patients diagnosed with systemic inflammatory response syndrome. Each of these biomarkers has advantages and disadvantages. The majority of studies have shown that a combination of inflammatory biomarkers and immune response related biomarkers may provide the best diagnostic advantage for rapid confirmation of sepsis.
Key words: sepsis, inflammatory biomarkers, immune regulatory biomarkers, lactate, procalcitonin