Biomarkers for sepsis: more than just fever and leukocytosis—a narrative review

A biomarker describes a measurable indicator of a patient's clinical condition that can be measured accurately and reproducibly. Biomarkers offer utility for diagnosis, prognosis, early disease recognition, risk stratification, appropriate treatment (theranostics), and trial enrichment for pati...

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Bibliographic Details
Published in:Critical care (London, England) Vol. 26; no. 1; pp. 14 - 31
Main Authors: Barichello, Tatiana, Generoso, Jaqueline S., Singer, Mervyn, Dal-Pizzol, Felipe
Format: Journal Article
Language:English
Published: London BioMed Central 06.01.2022
BioMed Central Ltd
Springer Nature B.V
BMC
Subjects:
Biological markers
Biomarker
Biomarkers
Care and treatment
Chemokines
Critical care
Critical Care Medicine
Cytokines
Diagnosis
Emergency Medicine
Gene expression
Genotype & phenotype
Health aspects
Humans
Identification and classification
Immune system
Infections
Intensive
Leukocytosis
Medicine
Medicine & Public Health
Metabolites
Mortality
Pathogens
Patients
Permeability
Prognosis
Proteins
Review
Sepsis
Sepsis - diagnosis
Sepsis-associated encephalopathy
Septic shock
Shock, Septic
Systemic inflammatory response
Systemic Inflammatory Response Syndrome
Transcription factors
Trauma
Tumor necrosis factor-TNF
United States
Systemic inflammatory response
Sepsis
Septic shock
Biomarker
Sepsis-associated encephalopathy
ISSN:1364-8535, 1466-609X, 1364-8535, 1466-609X, 1366-609X
Online Access:Get full text
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Summary:A biomarker describes a measurable indicator of a patient's clinical condition that can be measured accurately and reproducibly. Biomarkers offer utility for diagnosis, prognosis, early disease recognition, risk stratification, appropriate treatment (theranostics), and trial enrichment for patients with sepsis or suspected sepsis. In this narrative review, we aim to answer the question, "Do biomarkers in patients with sepsis or septic shock predict mortality, multiple organ dysfunction syndrome (MODS), or organ dysfunction?" We also discuss the role of pro- and anti-inflammatory biomarkers and biomarkers associated with intestinal permeability, endothelial injury, organ dysfunction, blood–brain barrier (BBB) breakdown, brain injury, and short and long-term mortality. For sepsis, a range of biomarkers is identified, including fluid phase pattern recognition molecules (PRMs), complement system, cytokines, chemokines, damage-associated molecular patterns (DAMPs), non-coding RNAs, miRNAs, cell membrane receptors, cell proteins, metabolites, and soluble receptors. We also provide an overview of immune response biomarkers that can help identify or differentiate between systemic inflammatory response syndrome (SIRS), sepsis, septic shock, and sepsis-associated encephalopathy. However, significant work is needed to identify the optimal combinations of biomarkers that can augment diagnosis, treatment, and good patient outcomes.
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ISSN:1364-8535
1466-609X
1364-8535
1466-609X
1366-609X
DOI:10.1186/s13054-021-03862-5