{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T21:50:58Z","timestamp":1766181058987,"version":"3.37.3"},"reference-count":83,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T00:00:00Z","timestamp":1516060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and\/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials. Routine laboratory investigations such as creatinine, bilirubin, platelet count and lactate are now critical elements in the diagnosis of sepsis and septic shock. With no biomarker sufficiently validated to rule out bacterial infection in the ED, there remains substantial interest in biomarkers representing various pathogenic pathways. New technologies for screening multiple genes and proteins are identifying unique network \u2018signatures\u2019 of clinical interest. Other future directions include rapid detection of bacterial DNA in blood, genes for antibiotic resistance and EMR\u2010based computational biomarkers that collate multiple information sources. Reliable, cost\u2010effective tests, validated in the ED to promptly and accurately identify sepsis, and to guide initial antibiotic choices, are important goals of current research efforts.<\/jats:p>","DOI":"10.1111\/1742-6723.12924","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T23:42:59Z","timestamp":1516146179000},"page":"4-12","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Review article: Sepsis in the emergency department \u2013 Part 2: Investigations and monitoring"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-1128","authenticated-orcid":false,"given":"Amith","family":"Shetty","sequence":"first","affiliation":[{"name":"Emergency Department Westmead Hospital  Sydney New South Wales Australia"},{"name":"Westmead Clinical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9921-4620","authenticated-orcid":false,"given":"Stephen PJ","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research in Emergency Medicine Harry Perkins Institute of Medical Research  Perth Western Australia Australia"},{"name":"Department of Emergency Medicine Royal Perth Hospital  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine The University of Western Australia  Perth Western Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-4552","authenticated-orcid":false,"given":"Gerben","family":"Keijzers","sequence":"additional","affiliation":[{"name":"School of Medicine Bond University  Gold Coast Queensland Australia"},{"name":"School of Medicine Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian M","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Tang","sequence":"additional","affiliation":[{"name":"Immunology Department Westmead Millennium Institute for Medical Research  Sydney New South Wales Australia"},{"name":"Nepean Clinical School The University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas","family":"de Groot","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Thompson","sequence":"additional","affiliation":[{"name":"Critical Care and Trauma Division George Institute for Global Health  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F","family":"Fraser","sequence":"additional","affiliation":[{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Critical Care Research Group The Prince Charles Hospital  Brisbane Queensland Australia"},{"name":"Intensive Care Unit St Andrew's War Memorial Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Finfer","sequence":"additional","affiliation":[{"name":"Division of Critical Care George Institute for Global Health  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Austin Hospital  Melbourne Victoria Australia"},{"name":"School of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Iredell","sequence":"additional","affiliation":[{"name":"Westmead Clinical School The University of Sydney  Sydney New South Wales Australia"},{"name":"Infectious Diseases Westmead Hospital, Western Sydney Local Health District  Sydney New South Wales Australia"},{"name":"Institute of Clinical Pathology and Medical Research, Pathology West  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0288"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2637"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12578"},{"key":"e_1_2_10_6_1","first-page":"9","article-title":"New sepsis definition changes incidence of sepsis in the intensive care unit","volume":"19","author":"Fullerton JN","year":"2017","journal-title":"Crit. Care Resusc."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03935-14"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.899"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1093\/jac\/dku515","article-title":"Antibiotic policies in acute English NHS trusts: implementation of \u2018Start Smart\u2010then Focus\u2019 and relationship with Clostridium difficile infection rates","volume":"70","author":"Llewelyn MJ","year":"2015","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2847"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2015-205645"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01555-07"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc12896"},{"key":"e_1_2_10_15_1","first-page":"157","article-title":"Biomarkers for neonatal sepsis: recent developments","volume":"4","author":"Mally P","year":"2014","journal-title":"Res. Rep. Neonatol."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.4.337"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2004.01044.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-007-7077-9"},{"key":"e_1_2_10_19_1","first-page":"2091","volume-title":"Biomarkers for Diagnosis of Sepsis in Patients with Systemic Inflammatory Response Syndrome: A Systematic Review and Meta\u2010Analysis","author":"Liu Y","year":"2016"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-8981(02)00101-8"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)00053-0"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30592-3"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/1354750X.2012.704645"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc3885"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-112"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002022"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/951532"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30294-1"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaa5993"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.2691"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms10261"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3005893"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1039\/C6MB00656F"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00697"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.7.2437-2444.2002"},{"key":"e_1_2_10_36_1","first-page":"85","article-title":"The utility of blood culture in patients with community\u2010acquired pneumonia","volume":"3","author":"Luna HIR","year":"2001","journal-title":"Ochsner J"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1086\/313525"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1086\/378291"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12696"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199302001-00004"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000298158.12101.41"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)00937-5"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01852049"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2006.01247.x"},{"key":"e_1_2_10_45_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20460","article-title":"Sepsis: the LightCycler SeptiFast test MGRADE(R), SepsiTest and IRIDICA BAC BSI assay for rapidly identifying bloodstream bacteria and fungi \u2010 a systematic review and economic evaluation","volume":"20","author":"Stevenson M","year":"2016","journal-title":"Health Technol. Assess."},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0127195"},{"key":"e_1_2_10_47_1","article-title":"Demise of PCR\/electrospray ionization\u2010mass spectrometry as an infectious diseases diagnostic tool","author":"Ozenci V","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.050385-0"},{"key":"e_1_2_10_49_1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ijantimicag.2014.02.010","article-title":"Prediction of major antibiotic resistance in Escherichia coli and Klebsiella pneumoniae in Singapore, USA and China using a limited set of gene targets","volume":"43","author":"Ginn AN","year":"2014","journal-title":"Int. J. Antimicrob. Agents"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2013.03.003"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0289"},{"key":"e_1_2_10_52_1","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1016\/j.clinbiochem.2013.05.069","article-title":"Plasma neutrophil gelatinase\u2010associated lipocalin as a biomarker for acute kidney injury in critically ill patients with suspected sepsis","volume":"46","author":"Kim H","year":"2013","journal-title":"Clin. Biochem."},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819cefa9"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2010.01349.x"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000861"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000132904.35713.A7"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200912-1918OC"},{"key":"e_1_2_10_59_1","first-page":"3","article-title":"Lactate clearance as a target of therapy in sepsis: a flawed paradigm","volume":"1","author":"Marik PE","year":"2013","journal-title":"Anaesthesiol. Perioper. Crit. Care Med."},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12894"},{"key":"e_1_2_10_61_1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.annemergmed.2014.02.023","article-title":"Many emergency department patients with severe sepsis and septic shock do not meet diagnostic criteria within 3 hours of arrival","volume":"64","author":"Villar J","year":"2014","journal-title":"Ann. Emerg. Med."},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00664.x"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja15.00657"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2007.02.036"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201604-0854OC"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12515"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-017-0436-3"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.12886"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302164"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3002557"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc10463"},{"key":"e_1_2_10_72_1","doi-asserted-by":"crossref","first-page":"e0182351","DOI":"10.1371\/journal.pone.0182351","article-title":"Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock","volume":"12","author":"Schenkman KA","year":"2017","journal-title":"PLoS One"},{"key":"e_1_2_10_73_1","doi-asserted-by":"crossref","first-page":"786","DOI":"10.5811\/westjem.2014.8.21357","article-title":"Noninvasive hemodynamic monitoring in emergency patients with suspected heart failure, sepsis and stroke: the premium registry","volume":"15","author":"Nowak RM","year":"2014","journal-title":"West. J. Emerg. Med."},{"key":"e_1_2_10_74_1","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1097\/CCM.0000000000001955","article-title":"An algorithm for systemic inflammatory response syndrome criteria\u2010based prediction of sepsis in a polytrauma cohort","volume":"44","author":"Lindner HA","year":"2016","journal-title":"Crit. Care Med."},{"key":"e_1_2_10_75_1","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1097\/CCM.0000000000002112","article-title":"Dynamic systemic inflammatory response syndrome monitoring: a reSIRSgence?","volume":"44","author":"Dellinger RP","year":"2016","journal-title":"Crit. Care Med."},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2017.08.007"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0503-3"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2004.12.006"},{"key":"e_1_2_10_79_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000742"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12444"},{"key":"e_1_2_10_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70323-7"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340051134"},{"key":"e_1_2_10_83_1","doi-asserted-by":"publisher","DOI":"10.1086\/421997"},{"key":"e_1_2_10_84_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-184"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1742-6723.12924","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.12924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T07:43:48Z","timestamp":1695541428000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.12924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,16]]},"references-count":83,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/1742-6723.12924"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.12924","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"type":"print","value":"1742-6731"},{"type":"electronic","value":"1742-6723"}],"subject":[],"published":{"date-parts":[[2018,1,16]]},"assertion":[{"value":"2017-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}