English 
Italian DOCUMENTI SIBIOC - SIBioC Documents
Volume:
Biochimica Clinica 2018; 42(1) 62-73
Pubblicato on-line:
January 25, 2018
DOI:
10.19186/BC_2018.006
Documento di consenso SIBioC-Medicina di Laboratorio e Academy of Emergency Medicine and Care (AcEMC) sull’utilizzo in Pronto Soccorso dei biomarcatori per la diagnosi di sepsi batterica
AUTORI
1Sezione di Biochimica Clinica, Università degli Studi di Verona, Verona
2Laboratorio Analisi Chimico-Cliniche, Istituto Fiorentino di Cura e Assistenza, Firenze
3Pronto Soccorso e Medicina d’Urgenza, Grande Ospedale Metropolitano Niguarda, Milano
4Dipartimento di Emergenza ed Accettazione, Azienda Ospedaliera di Alessandria, Alessandria
5Pronto Soccorso, Ospedale S. Orsola-Malpighi, Università degli Studi di Bologna, Bologna
6Struttura Complessa di Medicina di Laboratorio, AULSS 7 Pedemontana, Bassano del Grappa (VI)
7Laboratorio di Chimica Clinica ed Ematologia, Ospedale “San Bortolo”, Vicenza
8Medicina e Chirurgia d’Accettazione e d’Urgenza, ASUR Marche, Area Vasta 4 Fermo, Fermo
9Pronto Soccorso, Ospedale L. Sacco, Milano
10Unità Operativa Complessa Patologia Clinica, Presidio Ospedaliero Carlo Urbani, Jesi
11Pronto Soccorso e Medicina d’Urgenza, ASUI Udine, Udine
12Dipartimento di Medicina di Laboratorio e Anatomia Patologica, AUSL ed AOU di Modena, Modena
13Dipartimento di Biopatologia e Biotecnologie Mediche, Università degli Studi di Palermo, Palermo
14Pronto Soccorso e Medicina D’Urgenza, Azienda Ospedaliero-Universitaria di Parma, Parma
ABSTRACT
Biomarkers for diagnosing sepsis in the emergency department: a consensus document by SIBioCMedicina di Laboratorio and the Academy of Emergency Medicine and Care
This article is drafted as a consensus document involving eight members of the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC) and eight members of the Academy of Emergency Medicine and Care (AcEMC), to whom a questionnaire was submitted for obtaining opinions on some recommendations about the use of biomarkers for diagnosing sepsis and managing antibiotic therapy in the emergency department. These recommendations were drafted following the National Guidelines Program (PNLG). According to the cumulative consent, three “A” recommendations (strongly recommended indication) emerged, which include biomarker availability (always available on prescription), clinical use (always interpreted in according to clinical data) and timing of the request based on half-life of the analyte. Recommendations of type “B” (indications carefully considered) included a general agreement about the clinical usefulness of sepsis biomarkers, the combination of procalcitonin (PCT) and Creactive protein (CRP), the possibility to be free on prescription to the laboratory, the use of cut-offs favoring a high negative predictive value, the use of more analytically sensitive assays and the possibility of using PCT for monitoring antibiotic therapy, with timing of ordering defined according to the metabolism of the analyte. As regards the specific biomarkers, a similar “B” consensus has been reached for measuring both PCT and CRP, and for measuring lactic acid. The measurement of other biomarkers is discouraged except for presepsin, for which there is still substantial uncertainty in favor or against.