New Sepsis Biomarkers Research is AMAZING (Dr. François Ventura)

Advancements in Sepsis Biomarkers | Dr François Ventura

Dr François Ventura, an esteemed anesthesiologist and intensive care physician at the University Hospital in Geneva, Switzerland, highlights current research on early sepsis biomarkers, providing a comprehensive overview of the evolving landscape of sepsis diagnosis and management.

Introduction to Sepsis Biomarkers

Explanation of the essential components of sepsis: infection, inflammation, and organ dysfunction. Despite numerous biomarkers available, none are officially recommended for sepsis diagnosis as of 2023. Clinical evaluation remains the gold standard.

Challenges and Opportunities in Biomarker Utilisation

Dr Ventura highlights the limitations of relying solely on clinical evaluation, which can result in unnecessary antibiotic administration. A survey in Switzerland revealed that clinicians often prefer biomarkers over clinical scores, suggesting a potential role for biomarkers in improving diagnostic accuracy.

The Multifaceted Role of Biomarkers

Biomarkers could serve several purposes in sepsis management:

Screening: Early, pre-symptomatic detection of nosocomial sepsis.
Diagnosis: Rapid confirmation or exclusion of sepsis.
Monitoring: Assessing treatment efficacy and guiding antibiotic de-escalation.
Risk Stratification: Predicting patient outcomes.
Surrogate Endpoints: Estimating long-term prognosis.
Dr Ventura emphasises that not all these purposes are equally valuable in clinical practice, particularly for risk stratification and surrogate endpoints.

Criteria for an Ideal Sepsis Biomarker

According to a 2010 study, a sepsis biomarker should be affordable, sensitive, specific, user-friendly, rapid, and require minimal equipment. Additional criteria include minimal blood sample requirements and certification in major healthcare markets.

Current State of Sepsis Biomarker Research

Research has identified over 250 different sepsis biomarkers, including classical markers like CRP and PCT, and newer ones like interleukin-6 and pancreatic stone protein (PSP). Despite promising results, many new biomarkers lack extensive study.

Pancreatic Stone Protein (PSP)

PSP, a damage-associated molecular pattern, stands out for its ability to detect sepsis early. Studies show that PSP levels rise 2-3 days before clinical symptoms, offering a critical window for early intervention. PSP is also effective in rapid diagnosis and has been validated in multiple international studies.

Proposed Integration of Biomarkers in Clinical Practice
A combination of biomarkers for different stages of sepsis management:
- PSP for screening: Early detection of infection.
- PSP and CRP for diagnosis: Accurate identification of sepsis.
- PCT for monitoring: Guiding antibiotic therapy.
- Future Directions in Sepsis Biomarker Research

Future research should focus on defining specific uses for new biomarkers, applying standardised protocols, and avoiding comparisons with outdated markers. The integration of biomarkers with clinical pre-test probability scores and machine learning could enhance diagnostic accuracy.

Conclusion

Dr Ventura concludes by emphasising the potential of PSP, particularly when combined with CRP, to meet the ideal criteria for a sepsis biomarker. He underscores the importance of daily monitoring with PSP for early diagn

00:00 Introduction
00:33 Are biomarkers recommended in 2023 for the diagnosis of sepsis?
01:31 Could biomarkers for sepsis be useful?
02:47 What should a sepsis biomarker be used for?
04:40 What is the definition of early diagnosis of sepsis?
05:49 What should be the ideal criteria for a biomarker of sepsis?
07:19 What is the status of biomarker research in 2023?
09:05 Do you have an example of a novel biomarker?
12:42 What is your opinion in 2023 on novel biomarkers for sepsis?
13:37 What is your opinion in 2023 about the future of sepsis biomarker research?
15:01 Any concluding remarks?

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