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How to use biomarkers of infection or sepsis at the bedside

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Resumo: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.
Autores principais:Póvoa, Pedro
Outros Autores:Povoa, Pedro; Coelho, Luís; Dal-Pizzol, Felipe; Ferrer, Ricard; Huttner, Angela; Conway Morris, Andrew; Nobre, Vandack; Ramirez, Paula; Rouze, Anahita; Salluh, Jorge; Singer, Mervyn; Sweeney, Daniel A.; Torres, Antoni; Waterer, Grant; Kalil, Andre C.
Assunto:Antibiotic stewardship Biomarkers Diagnosis Intensive care unit Sepsis Critical Care and Intensive Care Medicine
Ano:2023
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade Nova de Lisboa
Idioma:inglês
Origem:Repositório Institucional da UNL

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