A Focus on Intra-Abdominal Sepsis with Biomarkers: A Literature Review

Abstract

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection according to the Third International Consensus Definitions for Sepsis and Septic Shock definitions. It is a clinical condition with high morbidity and mortality due to its complex pathophysiology and lack of a complete treatment. It constitutes a significant economic burden because it constitutes a substantial part of intensive care patients, and the treatment process is lengthy and costly. Therefore, early diagnosis and treatment of the disease are essential. After pneumonia, an essential source of sepsis is intra-abdominal infection. Due to the presence of multiple and polymicrobial sources of infection, abdominal sepsis progresses more seriously. The effective treatment of intra-abdominal infection consists of early recognition of the disease, control of the source, appropriate antibiotic therapy, and stabilization in the intensive care setting with an excellent surgical approach. We searched PubMed, EMBASE, MEDLINE, and the Cochrane Library. Two authors reviewed all identified abstracts and selected articles for full-text review. We included original studies assessing mediators in intra-abdominal sepsis. Inflammatory and protein mediators such as acute phase protein and chemokine cytokines play an essential role in intra-abdominal sepsis. In clinical practice, white blood cell count, C-reactive protein, and procalcitonin are the most used parameters in the definition of abdominal infection. Tumor necrosis factor-alpha, interleukin-6, high-mobility group protein B1, and presepsin are other markers with high diagnostic efficiency, even though they are not used routinely. Despite everything, there is a need for highly effective markers that can be used in the diagnosis and follow-up of sepsis. Great hope is attached to these markers. This review aims to discuss the importance of the most used markers in the diagnosis and follow-up of abdominal sepsis and the markers on which there are essential studies in light of current literature.

The value of preoperative neutrophil/lymphocyte ratio in predicting the severity of cholecystolithiasis with cholecystitis in elderly patients

“…Various prognostic scoring criteria based on inflammation have been proposed, such as the modified Glasgow prognostic score (mGPS), peripheral blood platelet-to-lymphocyte ratio (PLR), NLR, prognostic nutritional index, and CRP [ 27 ]. Studies have shown that these scores are strongly associated with the outcome or disease severity in patients with appendicitis, sepsis, heart failure, and sepsis [ 28 , 30 ]. One important limitation of these studies is the lack of exclusion of patients with diseases that may impact blood values.…”