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

Póvoa, Pedro; Coelho, Luís; Dal-Pizzol, Felipe; Ferrer, Ricard; Huttner, Angela; Conway Morris, Andrew; Nobre, Vandack; ... Kalil, Andre C; + view all (2023) How to use biomarkers of infection or sepsis at the bedside: guide to clinicians. Intensive Care Medicine , 49 pp. 142-153. 10.1007/s00134-022-06956-y. Green open access

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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.

Type: Article
Title: How to use biomarkers of infection or sepsis at the bedside: guide to clinicians
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00134-022-06956-y
Publisher version: https://doi.org/10.1007/s00134-022-06956-y
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Antibiotic stewardship, Biomarkers, Diagnosis, Intensive care unit, Sepsis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10163447
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