RT Book, Section A1 Manasia, Anthony A1 Narimasu, Jon A2 Oropello, John M. A2 Pastores, Stephen M. A2 Kvetan, Vladimir SR Print(0) ID 1136412810 T1 Biomarkers in Decision Making T2 Critical Care YR 1 FD 1 PB McGraw-Hill Education PP New York, NY SN 9780071820813 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1136412810 RD 2024/10/15 AB KEY POINTSAn ideal biomarker has a high sensitivity and allows for clinical applications in the diagnosis, staging, prognosis, and treatment of disease.Early identification of ischemia after the rupture or erosion of an atherosclerotic coronary plaque and before myonecrosis occurs is currently under investigation. Biomarkers of myocardial ischemia include choline, a chemical released during membrane damage; unbound free fatty acids, a chemical released by ischemic myocytes and ischemia-modified albumin.The cardiac biomarkers B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are elevated in 80% of patients who present to the emergency department (ED) with chronic heart failure (CHF).Neutrophil gelatinase-associated lipocalin (NGAL) is a novel serum biomarker that can identify acute kidney injury (AKI) early after the initial renal insult and can be reliably measured in the plasma by point-of-care immunoassay. NGAL levels were elevated up to 48 hours prior to the diagnosis of AKI based on the risk or renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease (RIFLE) criteria in a recent study.The use of procalcitonin (PCT) in the diagnosis and discrimination of bacterial infection, sepsis, and response to antibiotic therapy from noninfectious causes of systemic inflammatory response syndrome (SIRS) (ie, pancreatitis) is currently in use by some institutions.