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Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making

机译:关于即时医疗标记在急诊室路径决策中的作用的意见书

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摘要

Abstract Overcrowding of the emergency department (ED) is rapidly becoming a global challenge and a major source of concern for emergency physicians. The evaluation of cardiac biomarkers is critical for confirming diagnoses and expediting treatment decisions to reduce overcrowding, however, physicians currently face the dilemma of choosing between slow and accurate central-based laboratory tests, or faster but imprecise assays. With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training.
机译:摘要急诊科(ED)的人满为患正迅速成为全球性挑战,也是急诊医师关注的主要问题。心脏生物标志物的评估对于确认诊断和加快治疗决策以减少人满为患至关重要,但是,医生目前面临的选择是在缓慢的,准确的,基于中心的实验室检测还是快速但不精确的检测之间进行选择。随着技术的进步,即时检验(POCT)系统有助于对生物标志物(例如肌钙蛋白(cTn),脑钠尿肽(BNP)和中性白细胞明胶酶相关的脂钙蛋白(NGAL))进行高效且高通量的评估。在这种情况下,POCT可以帮助ED医生确认疾病的诊断,例如急性冠状动脉综合征,心力衰竭或肾脏损害。与传统的实验室方法相比,使用cTn,BNP和NGAL POCT已显示出可比的敏感性,特异性和失败率,但具有提供迅速准确的诊断,缩短住院时间并减轻ED负担的潜力。尽管有这种潜力,但只有在医院标准化程序中实施POCT并且ED人员接受适当的培训后,才能实现快速交付结果的全部优势。

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