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Intensivmedizin up2date 2018; 14(01): 23-33
DOI: 10.1055/s-0043-121124
Allgemeine Intensivmedizin
Georg Thieme Verlag KG Stuttgart · New York

Diagnostik der Sepsis

Tobias Schürholz
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Publication History

Publication Date:
07 March 2018 (online)

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Die Diagnose einer Sepsis sicher und schnell zu stellen, führt zur schnelleren Initiierung einer Therapie – und damit zu einer niedrigeren Letalität. Die Schwierigkeit liegt darin, einfache Infektionen von einer Sepsis zu unterscheiden. Die Identifizierung neuer Biomarker kann diese Hürde nicht allein überwinden. Die Kombination neuer Erkenntnisse in Pathophysiologie und Labordiagnostik können Fortschritte in der frühen Sepsisdiagnose erzielen.
Kernaussagen

  • Die Diagnose der Sepsis ist und bleibt diffizil.

  • Kein singulärer Biomarker hat einen positiven prädiktiven Wert, der sicher die an Sepsis erkrankten Patienten von den nicht erkrankten unterscheidet.

  • Ein Biomarker oder die Kombination aus mehreren Biomarkern unterstützt die Identifikation der Sepsispatienten und damit die Initiierung einer adäquaten Therapie.

  • Die klinische Beurteilung, durch Schulungsmaßnahmen geschärft, ist unerlässlich.

  • Zukünftig können molekularbiologische Methoden die Sepsisdiagnose schneller und sicherer machen.

Schlüsselwörter

Sepsis - septischer Schock - intensivmedizinische Diagnostik - Biomarker - SIRS - Inflammation
 

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