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Letter to the Editor
Sepsis biomarkers in severe burn patients: Cut-off point or time profile?
Biomarcadores de sepsis en pacientes quemados graves: ¿punto de corte o perfil temporal?
J.J. Egea-Guerrero
Corresponding author
, A. Rodríguez-Rodríguez
U.G.C. Cuidados Críticos y Urgencias, H.U. Virgen del Rocío, IBiS/CSIC/Universidad de Sevilla, Sevilla, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In regard to the review article on &#8220;Infections in critically burn patients&#8221; by Hidalgo et al&#46;&#44; we agree on the importance of developing new strategies to improve the infection diagnosis and management of these patients&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We concur on the lack of evidence in the use of serum biomarkers to differentiate Systemic Inflammatory Response Syndrome &#40;SIRS&#41; from sepsis in this population&#46; Probably&#44; this situation is a consequence of several factors&#46; Firstly&#44; sepsis diagnosis is difficult after severe thermal injury and requires the use of strict criteria described by the American Burn Association in 2007&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> Secondly&#44; authors exploring the utility of specific biomarkers of infection fail to apply the same sepsis yardstick&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">3&#8211;5</span></a> therefore published studies revealed a high level of heterogeneity&#46; It would be due to classical sepsis definition&#44; which includes little pathophysiological information&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">2&#44;6</span></a> Lastly&#44; mention that our group has explored the role of C-Reactive Protein &#40;CRP&#41; and Procalcitonin &#40;PCT&#41; for sepsis diagnosis in a small population of patients with severe burn injury&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> Our results show that the role of PCT in identifying infectious processes in critically burned patients is superior to CRP&#46; Specifically&#44; we found that increases in PCT levels showed a better discriminatory capacity for detecting sepsis&#44; as compared to changes in CRP levels&#46; Consequently&#44; we consider that use of static cut-off points in this complex situation provides less information than temporal changes&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Hopefully&#44; in the next years&#44; through well designed multicenter studies in severe burn injury patients&#44; we would be able to valid our hypothesis and to demonstrate that temporal profile of serum biomarkers might identify high-risk patients of sepsis after severe burn injury guiding antibiotic treatment accordingly in our intensive care units&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors of this paper have not received financial support or otherwise to perform this work&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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Article information
ISSN: 21735727
Original language: English
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2017 April 26 17 43
2017 March 21 0 21
2016 December 0 1 1
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Medicina Intensiva (English Edition)
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?