Francesco Cipulli

Critical care medicine is a highly complex field where diagnosing diseases and selecting effective therapies pose daily challenges for clinicians. In critically ill patients, biomarkers can play a crucial role in identifying and addressing clinical problems. Selecting the right biomarkers and utilizing them effectively can lead to more informed decisions, ultimately impacting patient outcomes. However, each biomarker has its strengths and limitations, making a thorough understanding essential for accurate diagnosis and treatment management. For instance, neuron-specific enolase (NSE) is commonly used to predict outcomes in out-of-hospital cardiac arrest (OHCA), procalcitonin (PCT) levels strongly correlate with bacterial infections, and NT-proBNP serves as a reliable indicator of cardiac stress. Additionally, serum creatinine (SCr) remains fundamental in renal diagnostics, while prealbumin helps differentiate catabolic and anabolic phases in critically ill patients. This narrative review highlights a carefully selected set of biomarkers known for their clinical utility and reliability in guiding critical care decisions. Further refining the application of biomarkers—especially by integrating them into a multimodal approach—will enhance clinicians’ ability to navigate the challenges of critical care, always striving to improve patient outcomes.

Introduction - Critical care medicine is a complex activity where knowledge, experience, intuition, and sometimes even luck converge. Diagnosing diseases and selecting effective therapies represent a daily challenges for clinicians, requiring them to analyze and process vast amounts of information. Patient’s medical history, clinical signs and symptoms, laboratory results, and radiological findings are just some of the elements that must be considered during routine practice. At times, the sheer volume of data can overwhelm doctors, exposing them to the risk of becoming lost in a maze of irrelevant information. This narrative review focuses on a curated set of biomarkers renowned for their reliability in supporting clinical decision-making. By leveraging these tools, we aim to streamline decision-making processes and enhance patient outcomes in the ICU’s high-stakes environment.

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