Rapid diagnosis, appropriate management, and time are the key factors for improving survival rate in many emergency clinical scenarios such as acute
myocardial infarction,
pulmonary embolism,
cerebral stroke, and
severe sepsis. Clinical signs and electrocardiographic, radiological, and echographic investigations associated with
biomarkers usually allow a quick diagnosis in all of the above situations, except
severe sepsis, in which the diagnosis in the early phases is often only presumptive. In
sepsis, microbiological cultures are still considered the 'gold standard' for diagnosis, whereas the numerous
biomarkers investigated are actually valuable only for patient stratification and evaluation of
clinical course. In this issue of
Critical Care, Que and colleagues describe the prognostic value of
pancreatic stone protein/regenerating
protein (PSP/reg) concentration in patients with severe
infections. The data reported are interesting, but several questions about this
biomarker arise, and further studies are needed to understand its role in
sepsis and clinical practice.