TY - JOUR
T1 - How to use biomarkers of infection or sepsis at the bedside
T2 - guide to clinicians
AU - Póvoa, Pedro
AU - Coelho, Luís
AU - Dal-Pizzol, Felipe
AU - Ferrer, Ricard
AU - Huttner, Angela
AU - Conway Morris, Andrew
AU - Nobre, Vandack
AU - Ramirez, Paula
AU - Rouze, Anahita
AU - Salluh, Jorge
AU - Singer, Mervyn
AU - Sweeney, Daniel A.
AU - Torres, Antoni
AU - Waterer, Grant
AU - Kalil, Andre C.
N1 - Publisher Copyright:
© 2022, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
KW - Antibiotic stewardship
KW - Biomarkers
KW - Diagnosis
KW - Intensive care unit
KW - Sepsis
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U2 - 10.1007/s00134-022-06956-y
DO - 10.1007/s00134-022-06956-y
M3 - Article
C2 - 36592205
AN - SCOPUS:85145504840
SN - 0342-4642
VL - 49
SP - 142
EP - 153
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 2
ER -