Biomarcadores emergentes e tecnologias ômicas no manejo da sepse e do choque séptico: do paradigma tradicional à medicina de precisão

Introduction: Sepsis is one of the leading causes of global hospital mortality, requiring early recognition for survival. Traditional biomarkers, such as lactate, C-reactive protein, and procalcitonin, present sensitivity and specificity limitations below 90%, hindering initial diagnosis and risk stratification. Objective: To evaluate the diagnostic accuracy and prognostic value of several emerging biomarkers and omic technologies in the management of sepsis in adults, contrasting their effectiveness with conventional markers. Method: Systematic review structured by PRISMA guidelines and the PICO strategy. PubMed/MEDLINE and CAPES Periodicals Portal databases were consulted in April 2026. From the 648 raw records retrieved, 12 original articles were selected after a careful eligibility analysis for qualitative synthesis. Results: Molecules such as bio-ADM and HBP outperformed lactate in predicting vascular instability and mortality within 30 days. PenKid and the [TIMP-2]·[IGFBP7] index allowed for the early detection of acute kidney injury before creatinine elevation. Presepsin demonstrated high accuracy in detecting bacterial immune activation. Omic technologies and machine learning algorithms reached high AUROCs in the early detection of clinical deterioration. Additionally, markers such as mHLA-DR and sTREM-1 identified PICS syndrome in survivors. Conclusion: The findings consolidate the transition to precision medicine, definitively overcoming the limited single-biomarker paradigm. The future of management lies in multiplex panels integrated with artificial intelligence clinical decision support systems to reduce global hospital mortality.