Use of biomarkers for diagnosis and treatment of sepsis/Uso de biomarcadores en el diagnostico temprano y el tratamiento de la sepsis

• Published in: Iatreia (Medellín, Colombia) Vol. 26; no. 4; pp. 457 - 466
• Main Authors: Agudelo, Jessica Maria Londono, Pulido, Cesar Daniel Nino, Vanegas, Natalia Andrea Hoyos, Barragan, Fabian Alberto Jaimes
• Format: Journal Article
• Language: Spanish
• Published: Universidad de Antioquia, Facultad de Medicina 01-10-2013; Universidad de Antioquia
• Subjects: Choque Séptico; Diagnosis; Diagnóstico; Prognosis; Pronóstico; Sepsis; Septic Shock
• ISSN: 0121-0793; 2011-7965

Background: Sepsis is a very complex clinical phenomenon in both its definition and pathophysiology. So far its diagnosis has been based only on clinical symptoms and signs together with the results of some laboratory tests. However, efforts are being done to find biomarkers that are able to identify sepsis or rule it out. and to serve as guide for treatment. Objective: This review describes the most thoroughly studied biomarkers of sepsis and their potential use, as well as the experience achieved in Medellin, Colombia, with research in this field. Methods: A search on this subject matter was carried out in PubMed, and a critical analysis was done of the most relevant papers found including those published in Colombia. Results and conclusions: More than 180 biomarkers have been studied, most of them for diagnostic and prognostic purposes. Unfortunately, none of them has exhibited the sensitivity and specificity required to be recommended for routine clinical practice. So far, procalcitonin has been the most promising biomarker. Doubtless, this line of research should be continued and reinforced. KEYWORDS Diagnosis: Prognosis: Sepsis: Septic Shock Introduccion: la sepsis es un fenomeno clinico muy complejo tanto en su definicion como en su fisiopatologia. Hasta ahora su diagnostico se ha basado solo en los sintomas y signos clinicos junto con los hallazgos de las pruebas de laboratorio. Por esta razon se ha tratado de encontrar biomarcadores que puedan identificar la sepsis o descartarla y servir como guia para el tratamiento. Objetivos: esta revision describe los biomarcadores mas estudiados en sepsis y su uso potencial, junto con la experiencia lograda con la investigacion al respecto en Medellin, Colombia. Metodologia: se llevo a cabo una busqueda en la base de datos de PubMedy se hizo un analisis critico de la literatura mas relevante incluyendo los estudios publicados en Colombia sobre este asunto. Resultados y conclusiones: se han estudiado mas de 180 biomarcadores, la mayoria con fines de diagnostico temprano y de pronostico. Ninguno ha sido lo suficientemente sensible y especifico como para recomendarlo de rutina en la practica clinica. La procalcitonina es, probablemente, el biomarcador mas promisorio hasta ahora; es indudable que esta linea de investigacion debe continuar abierta y en crecimiento. PALABRAS CLAVE Choque Septico; Diagnostico; Pronostico; Sepsis