TY - CHAP M1 - Book, Section TI - Molecular Biomarkers in Critical Care Medicine A1 - Walley, Keith R. A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. PY - 2023 T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - All biomarker measurements must be actionable, that is, they must direct action/decisions leading to improved patient outcomes. A limited number of actionable biomarkers have been developed in critical care medicine.Common functions of biomarkers include diagnostic, to follow response to therapy, to subphenotype, to identify patients who will likely respond to a specific therapy (theragnostic), to decrease heterogeneity in clinical trial cohorts, and prognostic.Measurements of single proteins have been the most common type of molecular biomarkers but miRNAs, gene expression arrays, DNA assays, other metabolites, and multiplex “omics” panels combining clinical variables with a variety of these molecular biomarkers are becoming common.Critical care medicine syndromes such as sepsis, shock, ARDS, and AKI result from diverse pathophysiological processes and disease states, so molecular biomarkers, which arise from specific (not diverse) metabolic pathways, are often insensitive and nonspecific. Using arrays of biomarkers to subphenotype critical illness syndromes into specific pathophysiologic processes or disease states is likely to greatly enhance the value of molecular biomarkers in directing therapeutic action targeted at the underlying pathophysiologic mechanisms. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/03 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1201799334 ER -