title: Advances in Biomarkers in Critical Ill Polytrauma Patients.
abstract: BACKGROUND
  The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries. The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient. In this paper we wish to summarize the recent studies of biomarkers useful for the intensive care unit (ICU) physician.
  
  
  METHODS
  For this study the available literature on specific databases such as PubMed and Scopus was thoroughly analyzed. Each article was carefully reviewed and useful information for this study extracted. The keywords used to select the relevant articles were "sepsis biomarker", "traumatic brain injury biomarker" "spinal cord injury biomarker", "inflammation biomarker", "microRNAs biomarker", "trauma biomarker", and "critically ill patients".
  
  
  RESULTS
  For this study to be carried out 556 original type articles were analyzed, as well as case reports and reviews. For this review, 89 articles with relevant topics for the present paper were selected. The critically ill polytrauma patient, because of the clinical complexity the case presents with, needs a series of evaluations and specific monitoring. Recent studies show a series of either tissue-specific or circulating biomarkers that are useful in the clinical status evaluation of these patients.
  
  
  CONCLUSIONS
  The biomarkers existing today, with regard to the critically ill polytrauma patient, can bring a significant contribution to increasing the survival rate, by adapting the therapy according to their expressions. Nevertheless, the necessity remains to research new non-invasive diagnostic methods that present with higher specificity and selectivity.
authors.forename: Marius
authors.initials: M
authors.lastname: Papurica
authors.forename: Alexandru F
authors.initials: AF
authors.lastname: Rogobete
authors.forename: Dorel
authors.initials: D
authors.lastname: Sandesc
authors.forename: Raluca
authors.initials: R
authors.lastname: Dumache
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Cradigati
authors.forename: Mirela
authors.initials: M
authors.lastname: Sarandan
authors.forename: Radu
authors.initials: R
authors.lastname: Nartita
authors.forename: Sonia E
authors.initials: SE
authors.lastname: Popovici
authors.forename: Ovidiu H
authors.initials: OH
authors.lastname: Bedreag
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D016638:Critical Illness; D003661:Decision Support Techniques; D005819:Genetic Markers; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D035683:MicroRNAs / Q000235:genetics; D009104:Multiple Trauma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000628:therapy; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D005819:Genetic Markers; D018836:Inflammation Mediators; D035683:MicroRNAs