tailieunhanh - Báo cáo y học: " Activated partial thromboplastin time waveform analysis as specific sepsis marker in cardiopulmonary bypass surgery"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Activated partial thromboplastin time waveform analysis as specific sepsis marker in cardiopulmonary bypass surgery. | Schneider et al. Critical Care 2010 14 104 http content 14 1 104 CRITICAL CARE COMMENTARY L__ Activated partial thromboplastin time waveform analysis as specific sepsis marker in cardiopulmonary bypass surgery Christian P Schneider Martin K Angele and Wolfgang H Hartl See related research by Delannoy etal. http content 13 6 R180 Abstract Throughout the last years several new diagnostic biomarkers have been introduced into clinical routine to identify a systemic inflammatory response syndrome SIRS or a septic state and to discriminate between these two entities. According to studies in selected patients measurement of these biomarkers may be advantageous under certain clinical conditions. On an individual basis however these sepsis markers usually lack an adequate negative or positive predictive power. Therefore physicians in charge still have to rely on a combination of personal experience and results from clinical or laboratory tests when deciding on a patient s therapy. For surgical patients a key problem consists of the time delay which is associated with the diagnosis of serious postoperative infections and which may negatively affect outcome. It is in this context where the activated partial thromboplastin time waveform analysis may represent a promising new method to discriminate between SIRS and sepsis thereby shortening the time to therapy. Nevertheless studies involving large patient populations will be necessary to prove the efficacy of this new diagnostic concept either as a single tool or in combination with the measurement of other biomarkers. Although our understanding of the pathophysiology of sepsis and of subsequently derived therapeutic approaches has advanced significantly in the past mortality of sepsis still remains unacceptably high. To improve this dilemma diagnostic laboratory tests are urgently required that Correspondence Department of Surgery Munich University .