title: Sepsis biomarkers.
abstract: Sepsis is the most frequent cause of death in non-coronary intensive care units (ICUs). In the past 10 years, progress has been made in the early identification of septic patients and in their treatment and these improvements in support and therapy mean that the mortality is gradually decreasing but it still remains unacceptably high. Leaving clinical diagnosis aside, the laboratory diagnostics represent a complex range of investigations that can place significant demands on the system given the speed of response required. There are hundreds of biomarkers which could be potentially used for diagnosis and prognosis in septic patients. The main attributes of successful markers would be high sensitivity, specificity, possibility of bed-side monitoring, and financial accessibility. Only a fraction is used in routine clinical practice because many lack sufficient sensitivity or specificity. The following review gives a short overview of the current epidemiology of sepsis, its pathogenesis and state-of-the-art knowledge on the use of specific biochemical, hematological and immunological parameters in its diagnostics. Prospective approaches towards discovery of new diagnostic biomarkers have been shortly mentioned.
authors.affiliation: Department of Clinical Biochemistry, Hematology and Immunology, Hospital Na Homolce, Prague, Czech Republic. Electronic address: miroslav.prucha@homolka.cz.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Prucha
authors.affiliation: University College London Hospitals, 235 Euston Rd, London NW1 2PG, United Kingdom(1).
authors.forename: Geoff
authors.initials: G
authors.lastname: Bellingan
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Zazula
mesh_terms: D000209:Acute-Phase Proteins; D015415:Biomarkers / Q000032:analysis* / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D002352:Carrier Proteins / Q000097:blood; D016207:Cytokines / Q000097:blood; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007362:Intensive Care Units; D007962:Leukocytes / Q000378:metabolism; D018950:Lipopolysaccharide Receptors / Q000097:blood; D008562:Membrane Glycoproteins / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000378:metabolism; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D002116:Calcitonin; D002352:Carrier Proteins; D016207:Cytokines; D005338:Fibrin Fibrinogen Degradation Products; D018950:Lipopolysaccharide Receptors; D008562:Membrane Glycoproteins; D010446:Peptide Fragments; D011498:Protein Precursors; D000099231:Lipopolysaccharide-Binding Protein; C036309:fibrin fragment D; C000594167:presepsin protein, human
keywords: Biomarkers; SIRS; Sensitivity; Sepsis; Specificity