title: Sepsis outside intensive care unit: the other side of the coin.
abstract: BACKGROUND
  A growing body of evidence points out that a large amount of patients with sepsis are admitted and treated in medical ward (MW). With most of the sepsis studies conducted in intensive care unit (ICU), these patients, older and with more comorbidities have received poor attention. Provided the differences between the two groups of patients, results of diagnostic and therapeutic trials from ICU should not be routinely transferred to MW, where sepsis seems to be at least as common as in ICU.
  
  
  METHODS
  We analyzed clinical trials on novel tools for an early diagnosis of sepsis published in the last two year adopting strict research criteria. Moreover we conducted a target review of the literature on non-invasive monitoring of severe sepsis and septic shock.
  
  
  CONCLUSIONS
  The combination of innovative and non-invasive tools for sepsis rule in/out, as quick alternatives to blood cultures (gold standard) with bedside integrated ultrasonography could impact triage, diagnosis and prognosis of septic patients managed in MW, preventing ICU admissions, poor outcomes and costly complications, especially in elderly that are usually highly vulnerable to invasive procedures.
authors.affiliation: Unit of Clinica Medica Generale e Terapia Medica, Surgical Health Sciences, Department of Medical, University of Trieste, Strada di Fiume Cattinara, Trieste, 447 34149, Italy, filippome@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: Mearelli
authors.forename: D
authors.initials: D
authors.lastname: Orso
authors.forename: N
authors.initials: N
authors.lastname: Fiotti
authors.forename: N
authors.initials: N
authors.lastname: Altamura
authors.forename: A
authors.initials: A
authors.lastname: Breglia
authors.forename: M
authors.initials: M
authors.lastname: De Nardo
authors.forename: I
authors.initials: I
authors.lastname: Paoli
authors.forename: M
authors.initials: M
authors.lastname: Zanetti
authors.forename: C
authors.initials: C
authors.lastname: Casarsa
authors.forename: G
authors.initials: G
authors.lastname: Biolo
mesh_terms: D000368:Aged; D015415:Biomarkers; D015897:Comorbidity; D006757:Hospital Units; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D018805:Sepsis
chemical_list: D015415:Biomarkers
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