Author: Dana R. Tomescu

Conventional and Modern Methods in the Diagnosis of Sepsis and Septic Shock: A Narrative Review

Background/Objectives: Sepsis and septic shock are critical conditions associated with high mortality rates and substantial impacts on healthcare systems. Accurate and rapid diagnosis is essential for the management of these conditions. The objective of this study is to assess the accuracy of contemporary and traditional methods for diagnosing sepsis and to determine whether improvements have been made concerning the integration of novel diagnostic approaches, to facilitate a prompt diagnosis, taking into account the rapid progression of complications associated with this disease. For this purpose, studies published between 2014 and 2024 were examined to highlight the benefits and limitations of each approach. Methods: A systematic literature review was conducted, including randomized clinical trials, observational studies, and retrospective studies assessing both conventional diagnostic methods (blood cultures and clinical scoring systems) and modern methods (rapid molecular tests, specific biomarkers, and machine learning algorithms). The studies included were selected based on strict design and methodology criteria to ensure a rigorous comparative evaluation of the interventions and technologies used in diagnosing and monitoring patients with sepsis. Results: A total of 23,822 patients were reviewed across the studies included in this systematic analysis. Modern methods, such as continuous monitoring through integrated biosensors and the use of molecular panels for pathogen detection, demonstrated high potential for the early and accurate diagnosis of sepsis. The reviewed studies suggest that these methods can significantly reduce diagnostic time and improve the ability to stratify mortality risk compared to conventional methods. Conclusions: Integrating modern diagnostic technologies, such as rapid pathogen identification tests and specific biomarkers, may complement traditional methods and bring significant benefits in the management of sepsis.

New Insights in Microcirculation Research in Sepsis

Sepsis remains a leading cause of morbidity and mortality worldwide, with certain high-risk populations—including elderly patients, neonates, immunocompromised individuals, those with chronic diseases, and pregnant women—experiencing worse outcomes. These groups exhibit distinct pathophysiological responses, which complicate diagnosis, treatment, and prognosis. Despite advancements in sepsis management, challenges persist in early risk stratification, individualized therapeutic strategies, and long-term recovery. Aim: This study aims to evaluate the impact of sepsis on high-risk populations, identify prognostic factors influencing clinical outcomes, and explore personalized treatment approaches to optimize patient management. Methodology: A systematic narrative review was conducted, following PRISMA guidelines, by analyzing peer-reviewed literature from 2015 to 2025. This study included the analysis of 80 scientific articles from eight international databases. Studies focusing on sepsis pathophysiology, microcirculatory dysfunction, diagnostic techniques, therapeutic interventions, and post-sepsis outcomes in high- risk populations were included. Results: Elderly patients demonstrated the highest sepsis-related mortality rates (>40%), while neonates and immunocompromised individuals exhibited delayed inflammatory responses, complicating diagnosis. Prognostic biomarkers such as IL-6 and IL-10 showed potential utility in these populations. Personalized fluid resuscitation, antimicrobial stewardship, and immune-modulating therapies were identified as critical to improving outcomes. Post-sepsis syndrome (PSS) was prevalent, particularly in survivors with chronic comorbidities and prolonged ICU stays. Conclusions: Optimizing sepsis management in high-risk populations requires a multidisciplinary, personalized approach, incorporating early biomarker-based diagnostics, precision-guided hemodynamic support, and tailored rehabilitation programs. Future research should focus on novel immunotherapies, antimicrobial resistance strategies, and long-term functional recovery in sepsis survivors.