Activated partial thromboplastin time waveform analysis as specific sepsis marker in cardiopulmonary bypass surgery

Throughout the last years, several new diagnostic biomarkers have
been introduced into clinical routine to identify a systemic
inflammatory response syndrome (SIRS) or a septic state and to
discriminate between these two entities. According to studies in
selected patients, measurement of these biomarkers may be
advantageous under certain clinical conditions. On an individual
basis, however, these sepsis markers usually lack an adequate
negative or positive predictive power. Therefore, physicians in
charge still have to rely on a combination of personal experience
and results from clinical or laboratory tests when deciding on a
patient's therapy. For surgical patients, a key problem consists of
the time delay which is associated with the diagnosis of serious
postoperative infections and which may negatively affect outcome.
It is in this context where the activated partial thromboplastin
time waveform analysis may represent a promising new method to
discriminate between SIRS and sepsis, thereby shortening the time
to therapy. Nevertheless, studies involving large patient
populations will be necessary to prove the efficacy of this new
diagnostic concept either as a single tool or in combination with
the measurement of other biomarkers.