Precision medicine in sepsis: usefulness of biomarkers In critically ill patientsbiomarkers In critically ill patient

Medicina de precisión en sepsis: utilidad de los biomarcadores en pacientes biomarcadores en pacientes críticamente enfermos

Published 2020-02-11

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Vol. 29 No. 2 (2020): Mayo - Agosto
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Review Articles
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Molano, D., Gómez, M., Beltrán, E., Villabón, M., Robayo Valbuena, I. F., Franco, F., Cárdenas, J., Estupiñán, Álvaro, Sánchez, G., Arévalo, I., & Zamora, J. (2020). Precision medicine in sepsis: usefulness of biomarkers In critically ill patientsbiomarkers In critically ill patient. Journal of Medicine and Surgery Repertoire, 29(2), 75-83. https://doi.org/10.31260/RepertMedCir.01217273.973
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Daniel Molano
Fundación Universitaria Ciencias de la Salud
    Perfil Google Scholar
    Mario Gómez
    Fundación Universitaria Ciencias de la Salud
      Edgar Beltrán
      Hospital de San José
        Mario Villabón
        Hospital de San José
          Ivan Felipe Robayo Valbuena
          Fundacion Universitaria de Ciencias de la Salud
            Felipe Franco
            Fundación Universitaria Ciencias de la Salud
              Jorge Cárdenas
              Fundación Universitaria Ciencias de la Salud
                Álvaro Estupiñán
                Fundación Universitaria Ciencias de la Salud
                  Guillermo Sánchez
                  Fundación Universitaria Ciencias de la Salud
                    Ingrid Arévalo
                    Hospital Universitario Ramón y Cajal
                      Javier Zamora
                      Hospital Universitario Ramón y Cajal
                        Show authors biography

                        Daniel Molano,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Mario Gómez,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Edgar Beltrán,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Mario Villabón,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Ivan Felipe Robayo Valbuena,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Felipe Franco,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Jorge Cárdenas,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Álvaro Estupiñán,

                        Medicina Crítica y Cuidado Intensivo, Fundación Universitaria de Ciencias de la Salud, Bogotá DC, Colombia.

                        Guillermo Sánchez,

                        Epidemiología, División de Investigaciones. Fundación Universitaria de Ciencias de la Salud. Bogotá DC. Colombia.

                        Ingrid Arévalo,

                        Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal - IRYCIS, CIBER de Epidemiologia y Salud Publica, Madrid - España.

                        Javier Zamora,

                        Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal - IRYCIS, CIBER de Epidemiologia y Salud Publica, Madrid - España.

                        For many years, critical care practice has been based on protocols and management guidelines categorized by pathologies or syndromes. Although mortality caused by various diseases such as sepsis, acute coronary syndrome and acute respiratory distress has decreased, clinical problems, particularly diagnosis and management, have not been completely resolved. A new option known as “precision medicine” is on the horizon, a prevention and treatment strategy based on individual variability. Sepsis is a syndrome encompassing multiple clinical phenotypes and genotypes coding and a prompt diagnosis is relevant to obtain better outcomes. To this moment the main approach has been the identification of microorganisms causing sepsis to distinguish sepsis from systemic inflammatory response (SIRS). Infectious diseases paradigm has changed during recent years due to studies demonstrating how septic patient immune response plays a key role in the development of the disease, with implications on diagnosis, prognosis and treatment, which may help change the approach in the next years thanks to a strategy based on precision medicine. Today microbiological identification and cultures continue to be the reference standard with several disadvantages such as turnaround time for test results predominantly in infections caused by resistant bacteria or fungi that may delay commencement of antibiotic therapy. The use of sepsis biomarkers determined by the individual´s inflammatory response to infection have been proposed as a useful alternative for establishing diagnosis and prognosis mainly in critically ill patients. We decided to conduct this narrative review on the usefulness of biomarkers in critically ill septic patients using a personalized medicine model.

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