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Abstract
Introduction: Although the traditional laboratory biomarkers and clinical criteria are used in the diagnosis, follow-up and monitoring of sepsis, none individually is sufficient. A new pediatric sepsis phenotypes approach has emerged to stratify subgroups of patients who could respond better to therapies and improve mortality. Objective: To describe and analyze biomarkers in the context of the pediatric sepsis phenotypes new approach, and reflect on the contribution from the emergency laboratory. Materials and methods: A bibliographic review was carried out using MEDLINE and LILACS databases with MeSH terms "pediatric" "sepsis" "phenotypes" and filters "in the last 5 years" and "birth-18 years". Development: Sepsis is a clinical entity still under debate, with a consensus regarding pediatric criteria. Certain sepsis markers of interest such as lactate, procalcitonin, and C-reactive protein have shown utility in pediatrics for: early detection and differentiation of other inflammatory conditions; guide treatment and assess severity, and predict mortality. However, sepsis is a heterogeneous syndrome and traditional markers have not been as reliable; and the development of new targeted therapies requires targeting subsets of patients. Three main phenotypes can be classified: inflammatory (exaggerated inflammatory response and increased proinflammatory cytokines), immunosuppressive (decreased immune response and increased production of anti-inflammatory cytokines), and coagulation (exaggerated activation of the coagulation system and formation of microthrombi).
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