Biomarkers in critical illness: have we made progress?

Abstract

Biomarkers have emerged as exemplary key players in translational medicine. Many have been assessed for timely recognition, early treatment, and adequate follow-up for a variety of pathologies. Biomarker sensitivity has improved considerably over the last years but specificity remains poor, in particular when two "marker-sensitive" conditions overlap in one patient. Biomarker research holds an enormous potential for diagnostic and prognostic purposes in postoperative and critically ill patients who present varying degrees of inflammation, infection, and concomitant (sub)acute organ dysfunction or failure. Despite a remarkable progress in development and testing, biomarkers are not yet ready for routine use at the bedside.

Early Enteral Nutrition Adequacy Mitigates the Neutrophil–Lymphocyte Ratio Improving Clinical Outcomes in Critically Ill Surgical Patients

“…Both overactivation and underactivation are associated with worse outcomes . Tumor necrosis factor‐alpha (TNF‐α), interleukin (IL)‐6, monocyte activation, and C‐reactive protein (CRP) are candidate biomarkers of inflammation, but they are not regularly measured in clinical practice because of cost, timeliness, or availability . In contrast, a complete blood count (CBC) with cell differential is routinely measured at intensive care unit (ICU) admission and serially in most critically ill patients.…”

“…1 Tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, monocyte activation, and C-reactive protein (CRP) are candidate biomarkers of inflammation, but they are not regularly measured in clinical practice because of cost, timeliness, or availability. [2][3][4][5] In contrast, a complete blood count (CBC) with cell differential is routinely measured at intensive care unit (ICU) admission and serially in most critically ill patients. In addition to the white blood cell count (WBC), this test battery also includes absolute neutrophil and lymphocyte counts.…”

Increased DCLK1 correlates with the malignant status and poor outcome in malignant tumors: a meta-analysis

“…It has been demonstrated that the early diagnosis and reliable prediction for recurrences are critical for the prognosis of cancer patients [ 3 ]. Of note, biomarkers are already important adjuvant tools for refining and optimizing diagnosis, treatment, and prognosis [ 4 ]. However, currently established biomarkers, due to limited validation and questionable prognostic values, could not qualify as reliable biomarkers for early diagnosis and prognosis assessment in clinical practice [ 5 ].…”

Comparison of serum procalcitonin level with erythrocytes sedimentation rate, C-reactive protein, white blood cell count, and blood culture in the diagnosis of bacterial infections in patients hospitalized in Motahhari hospital of Urmia (2016)

“…The sensitivity of biomarkers has considerably improved in recent years, but they still have weaknesses and require further examination. [23] The present study was conducted to compare the effectiveness of serum PCT with serum ESR, CRP, WBC count, and blood culture in the diagnosis of bacterial infection in patients hospitalized in infection control department of Motahhari Hospital of Urmia in 2016. According to the results, the average serum PCT, CRP, ESR, and WBC count was significantly higher in the experimental group than in the control group.…”