29 -8 (46) 2022 – Abduraimov T.F. – THE SIGNIFICANCE OF NEW DEFINITIONS AND SOME BIOMARKERS IN THE EARLY DIAGNOSIS OF CRITICAL SEPTIC CONDITIONS IN OBSTETRICS

THE SIGNIFICANCE OF NEW DEFINITIONS AND SOME BIOMARKERS IN THE EARLY DIAGNOSIS OF CRITICAL SEPTIC CONDITIONS IN OBSTETRICS

Abduraimov T.F. Republican Specialized Scientific and Practical Center for Obstetrics and Gynecology, Tashkent, Uzbekistan.

Resume

Sepsis in general and obstetric sepsis in particular continue to be one of the urgent and insufficiently studied medical problems at the present time. In 2016, new definitions and approaches were proposed in the diagnosis and treatment of sepsis, with the goal of early and effective interventions and the reduction of severe maternal morbidity and mortality. However, the role of biomarkers in the complex of early diagnosis of sepsis remains insufficiently clear. The article presents the results of a study of the significance of new terminology and biomarkers such as procalcitonin and C-reactive protein in the early diagnosis of sepsis and related critical conditions. It has been established that the use of diagnostic criteria “Sepsis-3” makes it possible to detect sepsis at an early stage, conduct standard intensive care in a timely manner, reduce the frequency of critical situations and increase the cost-effectiveness of therapy. At the same time, procalcitonin and C-reactive protein cannot serve as specific indicators of sepsis, but they make it possible to evaluate the effectiveness of ongoing treatment in dynamics and determine the volume and quality of antibiotic therapy.

Key words: sepsis, sepsis biomarkers, procalcitonin, C-reactive protein, SOFA scale, critical conditions.

First page

168

Last page

173

For citation: Abduraimov T.F. THE SIGNIFICANCE OF NEW DEFINITIONS AND SOME BIOMARKERS IN THE EARLY DIAGNOSIS OF CRITICAL SEPTIC CONDITIONS IN OBSTETRICS //New Day in Medicine 8(46)2022 168-173 https://clck.ru/sWmm3

LIST OF REFERENCES:

1. Габитова Н.А., Кедрова А.Г., Захарова М.А., Белоусова Д.Н. и соавт. Материнский сепсис: новое международное определение – новые возможности для улучшения исходов. Фарматека, том 29, №6, 2022, стр. 57-62.
2. Кочетков А.В., Гудилов М.С. Клинико-лабораторная диагностика и мониторинг гнойно-септических осложнений после операций на органах брюшной полости. // Новости хирургии. 2015;23(1):105-111.
3. Хаертынов Х.С., Анохин В.А., Бойчук С.В., Ризванов А.А. Сепсис и апоптоз // Гены и клетки. 2016. Т. 11, № 4. С. 18–21.
4. Albright CM, Ali TN, Lopes V, Rouse DJ, Anderson BL. The Sepsis in Obstetrics Score: a model to identify risk of morbidity from sepsis in pregnancy. // Am J Obstet Gynecol 2014;211:39.e1–8.
5. Albright CM, Has P, Rouse DJ, Hughes BL. Internal validation of the Sepsis in Obstetrics Score to identify risk of morbidity from sepsis in pregnancy. // Obstet Gynecol 2017;130:747–55.
6. Bauer ME, Bateman BT, Bauer ST, Shanks AM, Mhyre JM. Maternal sepsis mortality and morbidity during hospitalization for delivery: temporal trends and independent associations for severe sepsis. // Anesth Analg 2013;117:944–50.
7. Biomarkers Definitions Working Grou P. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001; Vol. 69: 89–95.
8. Bowyer L., Robinson H.L., Barrett H., et al. SOMANZ guidelines for the investigation and management sepsis in pregnancy. // Aust N Z J Obstet Gynaecol 2017;57:540–51.
9. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. // Obstet Gynecol. 2018 Sep;132(3):e103-e119.
10. Dianti M., Luna C.M. Do we need biomarkers for the follow-up and shortening of antibiotic treatment duration? Curr Opin Crit Care. 2018 Oct;24(5):361-369.
11. Mouncey P.R., Osborn T.M., Power G.S., et al. Trial of early, goal-directed resuscitation for septic shock. N Engl J Med 2015;372:1301–11.
12. Peres Bota D., Melot C., Lopes Ferreira F., Vincent J.L. Infection Probability Score (IPS): A method to help assess the probability of infection in critically ill patients. // Crit Care Med. 2003; Vol. 31: 2579–84.
13. Pierrakos C., Vincent J.L. Sepsis biomarkers: a review. // Crit Care. 2010; Vol. 14: R15.
14. Reinhart K., Meisner M. Biomarkers in the critically ill patient: procalcitonin. // Crit Care Clin. 2011; Vol. 27: 253–63.
15. Seymour C.W., Liu V.X., Iwashyna T.J. et al. Assessment of clinical criteria for  sepsis: for  the  Third International Consensus Definitions for  Sepsis and Septic Shock (Sepsis-3) // JAMA. – 2016. – Vol. 315, № 8. – P. 762–774.
16. Shankar-Hari M., Phillips G., Levy M. et al. Developing a new definition and assessing new clinical criteria for septic shock for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) // JAMA. – 2016. – Vol. 315, № 8. – P. 775–787.
17. Shapiro N.I., Trzeciak S., Hollander J.E., Birkhahn R. et al. A prospective, multicenter derivation of a biomarker panel to assess risk of organ dysfunction, shock, and death in emergency department patients with suspected sepsis. // Crit Care Med. 2009; Vol. 37: 96–104.
18. Surgers L, Valin N, Carbonne B, et al. Evolving microbiological epidemiology and high fetal mortality in 135 cases of bacteremia during pregnancy and postpartum. // Eur J Clin Microbiol Infect Dis 2013;32: 107–13.
19. Wacker C., Prkno A., Brunkhorst F.M., Schlattmann P. Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis. // Lancet Infect Dis. 2013; Vol. 13: 426–35.