Biomarkers

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The page below is a sample from the LabCE course Laboratory Methods to Aid in the Detection of Sepsis (retired 10/27/2022). Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Laboratory Methods to Aid in the Detection of Sepsis (retired 10/27/2022) (online CE course)
Biomarkers

An ideal biomarker for diagnosis of disease has these properties:
  • High sensitivity (accurately identifies the presence of disease and has few false-negatives)
  • High specificity (accurately detects the absence of disease and has few false-positives)
  • Relates to the extent of disease
  • Changes as the clinical condition evolves
A biomarker that is able to identify sepsis or determine which patients with sepsis are likely to develop severe sepsis, would be very useful. However, an ideal single marker for sepsis is still not available.
C-reactive protein (CRP), procalcitonin (PCT), and lactic acid (lactate) are currently the tests that are most often used to aid in the detection of sepsis. However, test specificities and sensitivities are not high and if these tests are used to presumptively diagnose sepsis prior to availability of the blood culture or other culture reports, the results must be interpreted along with the clinical assessment.
As mentioned earlier in the course, sepsis may include these symptoms:
  • A body temperature >38°C or <36°C
  • A heart rate >90 beats/minute
  • Respiratory rate >20 breaths/minute
  • An alteration in the white blood cell (WBC) picture, such as a count >12.0 x 109/L or < 4.0 x 109/L or >10% immature neutrophils
  • Altered mental status
  • Edema
  • Hyperglycemia in the absence of diabetes
  • Elevated CRP
  • Elevated PCT
  • Elevated lactic acid (septic shock)