Abstract
Despite years of research and multiple potential candidate biomarkers for sepsis, few have had sufficient sensitivity or specificity to be integrated into routine practice. There have been only 11 observational studies that have collected samples from patients presenting to the emergency department with suspected sepsis. This has resulted in gaps in the ability to accurately diagnose sepsis in patients presenting with infections and give an accurate prognosis for patients or their families. Recent work has shown the importance of immunothrombosis, particularly in the prognosis for patients admitted to the intensive care unit with sepsis. Significantly some of the most impactful markers are actually decreased. In this perspective we summarize the current sepsis biomarker literature, highlight the limitations, particularly in diagnosis, and suggest some strategies for moving this field forward.