Review article: Sepsis in the emergency department - Part 2: Investigations and monitoring

No Thumbnail Available
File version
Author(s)
Shetty, Amith
Macdonald, Stephen PJ
Keijzers, Gerben
Williams, Julian M
Tang, Benjamin
De Groot, Bas
Thompson, Kelly
Fraser, John F
Finfer, Simon
Bellomo, Rinaldo
Iredell, Jonathan
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2018
Size
File type(s)
Location
License
Abstract

Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials. Routine laboratory investigations such as creatinine, bilirubin, platelet count and lactate are now critical elements in the diagnosis of sepsis and septic shock. With no biomarker sufficiently validated to rule out bacterial infection in the ED, there remains substantial interest in biomarkers representing various pathogenic pathways. New technologies for screening multiple genes and proteins are identifying unique network ‘signatures’ of clinical interest. Other future directions include rapid detection of bacterial DNA in blood, genes for antibiotic resistance and EMR‐based computational biomarkers that collate multiple information sources. Reliable, cost‐effective tests, validated in the ED to promptly and accurately identify sepsis, and to guide initial antibiotic choices, are important goals of current research efforts.

Journal Title

Emergency Medicine Australasia

Conference Title
Book Title
Edition
Volume

30

Issue

1

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject

Clinical sciences

Clinical sciences not elsewhere classified

Health services and systems

Public health

Persistent link to this record
Citation
Collections