Aktuelle Aspekte zur Sepsisdiagnose

Zusammenfassung

Die frühe Diagnose der Sepsis in ihren unterschiedlichen Schweregraden ist essentiell für die spezifische Therapie. Sepsis und schwere Sepsis sind begleitet von den klinischen, biochemischen und immunologischen Zeichen einer systemischen Inflammation. Diese Zeichen sind jedoch wenig spezifisch, da sie bei einer Vielzahl von primär nicht-infektiösen Inflammationszuständen ebenfalls bestehen. Der mikrobiologische Nachweis einer der Organdysfunktion zugrundeliegenden Infektion gelingt nicht bei allen Patienten, ist zeitaufwendig und häufig irreführend. Es ist daher von Bedeutung, sensitive und spezifische Marker zu evaluieren, die eine frühe Diagnose der Sepsis ermöglichen. Während das C-reaktive Protein ein sensitiver Parameter für die Diagnose von Lokalinfektionen ist, scheint Procalcitonin der geeignetere Marker zur frühen Diagnose und Therapiekontrolle bei Patienten mit schwerer Sepsis und septischem Schock zu sein.

Summary

Early diagnosis of the different severities of septic inflammation is important for early implementation of specific therapies. Sepsis and severe sepsis are accompanied by clinical and laboratory signs of systemic inflammation. However, patients suffering from non-infectious inflammation may present with similiar signs and symptoms making it difficult to diagnose infection based on clinical findings alone. Bacteriological evidence of sepsis, though definitive and specific, may not be obtainable, is time-consuming and even may not occur concurrently with clinical signs of sepsis. It is therefore important to identify markers, which, by enabling an early diagnosis of sepsis and organ dysfunction, would allow early specific therapeutic interventions. Wheras C-reactive Protein is a more sensitive parameter for the diagnosis of non-systemic infections, Procalcitonin seems to be a useful parameter to improve the diagnosis and monitoring of therapy in patients with severe sepsis and septic shock.

Sepsis - Schwere Sepsis - Marker - Frühdiagnose

Sepsis - Severe sepsis - Markers - Early diagnosis

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