Sepsis at the Crossroads: Innovations in Critical Care Management, Diagnostic Tools, and Treatment Paradigms

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 1078

Special Issue Editor


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Guest Editor
Departement of Anesthesia and Intensive Care, ASST Nord Milano, Ospedale E Bassini, 20092 Cinisello Balsamo, Italy
Interests: respiratory care; respiratory physiology; ultrasound; lung imaging; pain medicine; anesthesiology; sepsi and new biomarkers; nutritional support in ICU; humanization of intensive care
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Special Issue Information

Dear Colleagues,

This Special Issue of Diagnostics serves as a guiding light for healthcare professionals and researchers, offering insights into the latest advancements sha** sepsis management. With a focus on critical care, precise diagnostics, and innovative treatments, this Special Issue brings together cutting-edge research, insightful reviews, and forward-thinking perspectives to tackle the complexities of sepsis. As sepsis remains a significant challenge in healthcare, this Special Issue endeavors the comprehensive exploration of recent breakthroughs, aiming to improve patient care and outcomes. Join us on this transformative journey as we navigate the evolving landscape of sepsis management together.

Dr. Paolo Formenti
Guest Editor

Manuscript Submission Information

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Keywords

  • sepsis and clinical recognition
  • septic shock
  • SOFA and organ dysfunction
  • acute kidney injury
  • renal replacement therapy
  • new biomarkers
  • new therapeutic options

Published Papers (2 papers)

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Research

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12 pages, 1383 KiB  
Article
Analytical Evaluation of Point-of-Care Finecare™ Procalcitonin Rapid Quantitative Test in Sepsis Population as Compared with Elecsys® BRAHMS Procalcitonin Immunoassay
by Mohd Zulfakar Mazlan, Wan Norlina Wan Azman, Najib Majdi Yaacob, Tan Say Koon and Nurul Khaiza Yahya
Diagnostics 2024, 14(11), 1080; https://doi.org/10.3390/diagnostics14111080 - 22 May 2024
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Abstract
The study compared two plasma procalcitonin (PCT) assays, the point of care (POC) Finecare™ Procalcitonin Rapid Quantitative Test and the Elecsys® BRAHMS PCT immunoassay, in sepsis ICU patients. Forty-one plasma samples were analyzed, showing a strong correlation (r = 0.98) and no [...] Read more.
The study compared two plasma procalcitonin (PCT) assays, the point of care (POC) Finecare™ Procalcitonin Rapid Quantitative Test and the Elecsys® BRAHMS PCT immunoassay, in sepsis ICU patients. Forty-one plasma samples were analyzed, showing a strong correlation (r = 0.98) and no significant difference in PCT values. The mean POC PCT value was 4.46 ng/mL (SD 8.68), and for laboratory BRAHMS PCT, it was 4.67 ng/mL (SD 10.03). The study found a strong linear relationship between plasma POC PCT and laboratory BRAHMS PCT (r = 0.98). Different regression methods showed varying intercepts and slopes: Ordinary Least Squares had an intercept of 0.49 and a slope of 0.85; Deming regression showed an intercept of 0.43 and a slope of 0.86; Passing–Bablok regression showed an intercept of 0.02 and a slope of 1.08. Precision results for cut-offs of 0.5 ng/mL were a coefficient of variation (CV) of 5%, and for 2.5 ng/mL, the CV was 2.5%. The Pearson correlation coefficient (r) for linearity was ≥0.99. The study revealed no significant difference between the POC Finecare™ PCT and Elecsys® BRAHMS PCT immunoassay in sepsis samples from ICU patients, supported by strong correlation, minimal bias, a consistent CV, and linearity. Full article
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Review

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15 pages, 2289 KiB  
Review
Presepsin in Critical Illness: Current Knowledge and Future Perspectives
by Paolo Formenti, Miriam Gotti, Francesca Palmieri, Stefano Pastori, Vincenzo Roccaforte, Alessandro Menozzi, Andrea Galimberti, Michele Umbrello, Giovanni Sabbatini and Angelo Pezzi
Diagnostics 2024, 14(12), 1311; https://doi.org/10.3390/diagnostics14121311 - 20 Jun 2024
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Abstract
The accurate identification of infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, alongside cost and accessibility issues. Consequently, there is a pressing need for a marker that is economically feasible, [...] Read more.
The accurate identification of infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, alongside cost and accessibility issues. Consequently, there is a pressing need for a marker that is economically feasible, rapid, and reliable. Presepsin (PSP), also known as soluble CD14 subtype (sCD14-ST), has emerged as a promising biomarker for early sepsis diagnosis. PSP, derived from soluble CD14, reflects the activation of monocytes/macrophages in response to bacterial infections. It has shown potential as a marker of cellular immune response activation against pathogens, with plasma concentrations increasing during bacterial infections and decreasing post-antibiotic treatment. Unlike traditional markers such as procalcitonin (PCT) and C-reactive protein (CRP), PSP specifically indicates monocyte/macrophage activation. Limited studies in critical illness have explored PSP’s role in sepsis, and its diagnostic accuracy varies with threshold values, impacting sensitivity and specificity. Recent meta-analyses suggest PSP’s diagnostic potential for sepsis, yet its standalone effectiveness in ICU infection management remains uncertain. This review provides a comprehensive overview of PSP’s utility in ICU settings, including its diagnostic accuracy, prognostic value, therapeutic implications, challenges, and future directions. Full article
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