Sepsis, severe sepsis and septic shock are some of the most serious affections which threaten the lives of the patients who come to the Emergency Department and which require fast treatment because the more severe the sepsis was, the higher the mortality, up to 50% higher in severe sepsis. That is why, at present, the 2013 Guides of Surviving Sepsis Campaign recommend that the potential source of infection should be confirmed as soon as possible, in the first 6 hours since the patient arrived in the Emergency Unit if possible, moreover the large spectrum antibiotics therapy must be administered in one hour after the severe sepsis or the septic shock were identified. That is why the identification of these patients at risk is very important and this identification can only be made using POCT type devices. This type of devices has the capacity to make precise determinations, in a short time (15-17 minutes), using minimum quantities of integral blood, without using test tubes, sepsis biomarkers and other additional material. The possibility to fast diagnose sepsis, offers the doctors from the Emergency Department, the capacity to fast initiate an antibiotic treatment, to hospitalize the patient and at the same time, it gives them the certainty that they did not miss the sepsis diagnosis, thus avoiding the situation of malpractice. A preliminary study, regarding the sepsis biomarkers, which took place in the Emergency Unit of University Central Emergency Military Hospital, is also presented within this article.
Introduction: Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to an infection1 and also an important worldwide health problem. Recent progresses in understanding pathogenesis are reflected in increasing emphasis put on time (Sepsis Update 2018 decreased the time for diagnosis and treatment from 3- 6 hs Sepsis- 2 to 1 hour). The aim of the study was to combine an early warning score (increased sensitivity- NEWS2) and a biomarker (increased specificity- presepsin) in order to detect earlier an acute illness (infection) before becoming life-threatening. Materials and methods: It was a retrospective, single-center observational cohort study of 125 consecutive patients who were diagnosed with systemic inflammatory response syndrome between July 2016 and July 2018 at Emergency Department of “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania in order to determine sooner, which patient will further develop a sepsis. We used the area under receiver–operator characteristic curves (AUC) to assess the overall discriminatory power of NEWS2, MEDS and presepsin in detecting sepsis, septic shock and the probability of death on admission and compared them with combined scores between NEWS2 and presepsin. Results: Using a combined score and a simple algorithm, the NEWS2 score had changed (12,8%) for 16 patients. For 10 out of 95 (10,52%) without sepsis and 6 out of 30 (20%) of septic patients, more points were added to NEWS2 meaning that more septic patients were diagnosed before an infection become life-threatening Conclusions: In the present study, we have tried to assess the impact of a monitoring score and a rapid POCT biomarker, in a condition when time is of critical importance. Using a verified early warning score, NEWS2, with increased sensibility and low specificity and presepsin, POCT biomarker with increased specificity, we diagnosed sepsis earlier in a number of cases.
Background: NT-proB-type Natriuretic Peptide (BNP) (NT-pro BNP) is one of the biomarkers that has been studied in recent decades in connection with pediatric heart failure (HF) and congenital heart disease (CHD). Recently, infants hypothesized that serum. NT-pro BNP levels might be a good predictor of septicemia severity and response to treatment and prognosis in these patients. This study investigated the relationship between serum natriuretic type B peptide level and neonatal sepsis. Materials and Method: In this case-control study, all full-term and pre-term neonates admitted to children’s Hospital, Tabriz- Iran(2021), with sepsis and a septicemia diagnosis were confirmed after obtaining consent. The study was deliberately entered by the patient's parents or legal guardian. Complete Blood Count with Differential (CBC/Diff ), C - reactive protein (CRP) , Bacterial Culture (B/C) , Urine Analyze(U/A),Urine Culture (U/C) ,NT-pro BNP were checked and finally compared with laboratory results of the same number of infants who did not have clinical and laboratory symptoms of sepsis. After collecting samples, laboratory results, including serum levels of NT-pro BNP, were compared in case and control groups. Results: One hundred patients were studied in two groups. Thirty-eight patients (38%) were boys, and 62 patients (62%) were girls. The mean age of the patients was 7.58±7.46 days. The mean weight of the studied patients was 2811.80±620.33 grams, with a median of 2855 grams. The most common clinical symptom observed in patients in the case group was fever (100%) followed by Poor feeding (84%). In the control group, all patients had jaundice. Neonates with sepsis had significantly higher initial pro-BNP values than the control group (10023.80 vs. 2247.20; p=0.001). The NT-pro BNP level cut-off point in predicting the final treatment status and mortality of neonates with sepsis was 9583 pg/ml with 97.7% sensitivity and 93.6% specificity. Conclusion: Measurement of serum level of NT-Pro BNP in neonates with sepsis at the time of clinical signs with 97.7% sensitivity and 93.6% specificity with a cut-off point of 9583 is an important prognostic factor in the therapeutic management of patients.
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.
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.
