Diagnostic accuracy of various biomarkers of sepsis (serum pro-calcitonin, high-sensitivity C-reactive protein, and C-reactive protein) and band cell percentage in critically lll patients: A prospective, observational, cohort study

Gupta, B. S.; Das, Badri Prasad; Mhaske, Vanita R; Tomar, Shubham; Rastogi, Kapil

doi:10.4103/aer.aer_3_21

Cited by 1 publication

(2 citation statements)

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“…Biomarkers such as PCT and CRP deployed with rapid turnaround times, have been used as adjuncts in the early diagnosis of sepsis while awaiting microbiologic culture results (87–89). When used in conjunction with clinical assessment, these biomarkers may guide antimicrobial therapy, especially its discontinuation, and thus reduce unnecessary antimicrobial exposure in hospitalized patients, including those in the ICU (90–93).…”

Section: Rapid Biomarker Testingmentioning

confidence: 99%

“…Testing for SARS-CoV-2 using a NAAT on a nasopharyngeal swab, mid-turbinate swab, anterior nasal swab, saliva, or a combined anterior nasal/oropharyngeal swab, and if negative and a COVID-19 lower respiratory tract infection is suspected, lower respiratory secretions (e.g., sputum, tracheal aspirate, bronchoalveolar lavage fluid) should be considered (85); the reader is referred to the COVID-19 molecular diagnostic testing guideline from the IDSA https://www.idsociety.org/practice-guideline/ covid-19-guideline-diagnostics (86). Rationale: Biomarkers such as PCT and CRP deployed with rapid turnaround times, have been used as adjuncts in the early diagnosis of sepsis while awaiting microbiologic culture results (87)(88)(89). When used in conjunction with clinical assessment, these biomarkers may guide antimicrobial therapy, especially its discontinuation, and thus reduce unnecessary antimicrobial exposure in hospitalized patients, including those in the ICU (90-93).…”

Section: Testing For Viral Pathogensmentioning

confidence: 99%

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Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU

O’Grady,

Alexander,

Alhazzani

et al. 2023

Critical Care Medicine

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RATIONALE: Fever is frequently an early indicator of infection and often requires rigorous diagnostic evaluation. OBJECTIVES: This is an update of the 2008 Infectious Diseases Society of America and Society (IDSA) and Society of Critical Care Medicine (SCCM) guideline for the evaluation of new-onset fever in adult ICU patients without severe immunocompromise, now using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. PANEL DESIGN: The SCCM and IDSA convened a taskforce to update the 2008 version of the guideline for the evaluation of new fever in critically ill adult patients, which included expert clinicians as well as methodologists from the Guidelines in Intensive Care, Development and Evaluation Group. The guidelines committee consisted of 12 experts in critical care, infectious diseases, clinical microbiology, organ transplantation, public health, clinical research, and health policy and administration. All task force members followed all conflict-of-interest procedures as documented in the American College of Critical Care Medicine/SCCM Standard Operating Procedures Manual and the IDSA. There was no industry input or funding to produce this guideline. METHODS: We conducted a systematic review for each population, intervention, comparison, and outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the GRADE approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak or as best-practice statements. RESULTS: The panel issued 12 recommendations and 9 best practice statements. The panel recommended using central temperature monitoring methods, including thermistors for pulmonary artery catheters, bladder catheters, or esophageal balloon thermistors when these devices are in place or accurate temperature measurements are critical for diagnosis and management. For patients without these devices in place, oral or rectal temperatures over other temperature measurement methods that are less reliable such as axillary or tympanic membrane temperatures, noninvasive temporal artery thermometers, or chemical dot thermometers were recommended. Imaging studies including ultrasonography were recommended in addition to microbiological evaluation using rapid diagnostic testing strategies. Biomarkers were recommended to assist in guiding the discontinuation of antimicrobial therapy. All recommendations issued were weak based on the quality of data. CONCLUSIONS: The guidelines panel was able to formulate several recommendations for the evaluation of new fever in a critically ill adult patient, acknowledging that most recommendations were based on weak evidence. This highlights the need for the rapid advancement of research in all aspects of this issue—including better noninvasive methods to measure core body temperature, the use of diagnostic imaging, advances in microbiology including molecular testing, and the use of biomarkers.

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Section: Rapid Biomarker Testingmentioning

confidence: 99%