title: [Usefulness of inflammation and infection biomarkers in the Emergency Department].
abstract: Infectious processes account for 10% of patient seen in the emergency department. To administer antibiotics early, and before any other therapeutic-diagnostic decisions (complementary tests, microbiological samples, intensity of hemodynamic support, need for admission, etc.) have direct repercussions on the survival of patients with severe bacterial infections (bacteremia, severe sepsis or septic shock). In this context, the emergency department represents a critical level where the suspicion of infection and it diagnosis is made and treatment is started, and the progression and prognosis will be determined by the speed of this action. However, the clinical manifestations of infectious diseases are often non-specific and variable which makes early recognition of these patients and situations difficult. Inflammation and infection biomarkers have been around for years as helpful tools for improving emergency medical diagnoses and management of infection in the emergency department. The aim of this review is to summarize the published scientific evidence, in order to clarify the existing controversies, comparing the usefulness of the major biomarkers of inflammation and infection. It will alas suggest recommendations for their use in order to improve diagnosis, prognostic evaluation and management of infected patients in the emergency department.
authors.affiliation: Servicio de Urgencias, Complejo Hospitalario de Toledo, Toledo, España. Electronic address: agustinj@sescam.jccm.es.
authors.forename: Agustín
authors.initials: A
authors.lastname: Julián-Jiménez
authors.affiliation: Servicio de Microbiología Clínica, Hospital Clínico San Carlos, Madrid, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Candel-González
authors.affiliation: Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España.
authors.forename: Juan
authors.initials: J
authors.lastname: González Del Castillo
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000032:analysis; D004630:Emergencies; D004636:Emergency Service, Hospital; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000378:metabolism; D007249:Inflammation / Q000175:diagnosis* / Q000378:metabolism; D017410:Practice Guidelines as Topic
chemical_list: D015415:Biomarkers
keywords: Bacteremia; Bacteriemia; Biomarcadores; Biomarkers; C-reactive protein; Emergency department; Lactate; Lactato; Pro-adrenomedullin; Proadrenomedulina; Procalcitonin; Procalcitonina; Proteína C reactiva; Sepsis; Septic shock; Shock séptico; Urgencias