Sepsis biomarkers

• The laboratory diagnosis of sepsis is a mosaic of methodological approaches which are vital to the integration of the clinical picture.
• There are a number of parameters across laboratory branches that are used in diagnostics with different utility and penetration.
• There is no such thing as”a magic bullet“in the diagnosis of sepsis, the clinical diagnosis [with general variables, inflammatory variables, haemodynamic variables, organ dysfunction variables and tissue perfusion variables remains the gold standard.

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.