Laboratory Methods to Aid in the Detection of Sepsis

Author: Lynne Brodeur, MA, MLS(ASCP)
Reviewers: Julie Ann West, PhD, MLS(ASCP)CM SM(ASCP)CM and Laurie Bjerklie, MA, MLS(ASCP)CM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Clinical Chemistry/UA/Toxicology): 1 hour(s)

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This course discusses sepsis and the laboratory tests that are used to detect and intervene in its progression to severe sepsis and septic shock. The usefulness and limitations of C-reactive protein, procalcitonin, and lactic acid concentration are covered in the course. Novel biomarkers that may prove useful as methods for early detection of severe sepsis in the near future are also discussed.

Objectives

  • Define sepsis, severe sepsis, and septic shock.
  • Explain how C-reactive protein, procalcitonin, and lactic acid are used to aid in the detection and monitoring of sepsis.
  • State the mechanisms of C-reactive protein, procalcitonin, and lactic acid.
  • Discuss novel sepsis biomarkers that are currently being researched.

Course Outline

  • Development and Progression of Sepsis
    • Introduction
    • Systemic Inflammatory Response Syndrome and Sepsis
    • Sepsis
    • Additional Testing for Diagnosis of Sepsis
    • Septic Shock
    • Sepsis and Bacterial Toxins
    • Which of the following is not an indicator of sepsis?
    • True or False: Blood cultures are critical for diagnosing sepsis. Sets of blood cultures may be collected at one-hour intervals or all at once if necessary.
  • Laboratory Tests Used in the Detection of Sepsis
    • Biomarkers
    • Sensitivity versus Specificity
    • C-Reactive Protein
    • Procalcitonin
    • Procalcitonin as a Sepsis Biomarker
    • Lactic Acid
    • Lactic Acid, continued
    • Which of the following statements regarding a biomarker with high sensitivity is true?
    • True or False: C-reactive protein (CRP) is more useful for monitoring response to antibiotics and predicting prognosis than diagnosing sepsis.
    • True or False: Blood lactic acid concentration indicates impaired circulation and tissue oxygenation in critically ill patients. If these conditions are present, blood lactic acid concentration will decrease below the lower end of the established reference range.
  • Mechanisms of C-Reactive Protein, Procalcitonin, and Lactic Acid
    • Mechanism of C-Reactive Protein
    • Mechanism of Procalcitonin
    • Mechanism of Lactic Acid
    • Other Causes of Increased Lactic Acid Concentration
    • In healthy individuals, procalcitonin is synthesized by which cells in the body?
    • True or False: An elevated lactate level is known to be associated with increased mortality.
  • Future Perspectives
    • Increase in Sepsis Cases
    • Novel Biomarkers That Focus on Immunosuppression
    • Interleukin-6 and Other Candidates
    • The Future: Rapid Point-of-Care (POC) Testing
    • Which of the following is believed to be the cause of the rise seen each year in the number of cases of sepsis?
    • True or False: Over 250 biomarkers for sepsis have been researched, and most have been deemed acceptable for use in the US (approved by the FDA).
  • References
    • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, and MLS students. This course may also be of interest to other health care professionals who are involved in diagnosis and treatment of sepsis.
Author Information: Lynne Brodeur, MA, MLS(ASCP)CM holds a master of arts degree in teaching. She is currently a full time lecturer at the University of Massachusetts Dartmouth and works per diem in Clinical Chemistry at St. Luke's Hospital in New Bedford, MA.
Reviewer Information: 
Dr. Julie Ann West is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). In addition, Dr. West has earned a PhD in Public Health - Infectious Disease Epidemiology - and is Certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a Technical Specialist, Safety Officer, Educator, and Lead in the Veterans Administration Healthcare System and has prior experience as an Administrative Laboratory Director.
Laurie Bjerklie, MA, MLS(ASCP)CM, is an Education Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
Content Description: This course discusses sepsis and the laboratory tests used to detect and intervene in its progression to severe sepsis and septic shock. It covers the usefulness and limitations of C-reactive protein, procalcitonin, and lactic acid concentration. Novel biomarkers that may prove useful as methods for early detection of severe sepsis in the near future are also discussed.