Pub Date : 2018-09-01DOI: 10.1097/POC.0000000000000168
L. Coppolino
INTRODUCTION TO COMPASS Fulfilling andmanaging all documentations for point-of-care testing (POCT) competency assessments can be a challenging process in today's laboratory environment. Even with diligent performance of assessment activities for all POCT personnel, it can be difficult to ensure that all pieces of evidence are tracked, stored, and readily available during accreditation inspections. Not surprisingly, one of the most common laboratory inspection citations involves nonconformance with current competency assessment standards. The era of cloud-based laboratory software has allowed for a different approach to aid in competency management while meeting the needs of the modern laboratory and POCT personnel. MediaLab's Compass solution was designed to automate competency processes—providing the ability for point-of-care coordinators to deliver custom competency assessments to employees that perform POCT or provider-performed microscopy (PPM) procedures. The Compass program creates custom competency assessment profiles for each device or test method, which are assigned, completed, and tracked online to present a complete picture of your POCT and PPM competency assessment program.
{"title":"MediaLab Compass for Point-of-Care Testing and Provider-Performed Microscopy","authors":"L. Coppolino","doi":"10.1097/POC.0000000000000168","DOIUrl":"https://doi.org/10.1097/POC.0000000000000168","url":null,"abstract":"INTRODUCTION TO COMPASS Fulfilling andmanaging all documentations for point-of-care testing (POCT) competency assessments can be a challenging process in today's laboratory environment. Even with diligent performance of assessment activities for all POCT personnel, it can be difficult to ensure that all pieces of evidence are tracked, stored, and readily available during accreditation inspections. Not surprisingly, one of the most common laboratory inspection citations involves nonconformance with current competency assessment standards. The era of cloud-based laboratory software has allowed for a different approach to aid in competency management while meeting the needs of the modern laboratory and POCT personnel. MediaLab's Compass solution was designed to automate competency processes—providing the ability for point-of-care coordinators to deliver custom competency assessments to employees that perform POCT or provider-performed microscopy (PPM) procedures. The Compass program creates custom competency assessment profiles for each device or test method, which are assigned, completed, and tracked online to present a complete picture of your POCT and PPM competency assessment program.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75036690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000159
D. Barcellona, L. Fenu, F. Marongiu
Abstract Point of care testing (POCT) international normalized ratio (INR) devices are widely accepted for self-testing and self-management of vitamin K antagonists (VKAs). The aim of this work was to evaluate the performance of a POCT at our thrombosis centre aiming at reducing the time spent by patients for blood sampling and dose adjustment. A total of 101 consecutive oral anticoagulated patients (53 M, 48 F, median age 74 years, 23–89) were enrolled in the study that consisted of 2 different phases. In the first, standard monitoring was carried out for 3 months; during this period, the INR value was also determined by capillary blood sample with the use of a POCT to compare the INR values obtained with the two systems. In the second phase, patients were monitored for 3 months using only the CoaguChek XS Plus. The Bland-Altman test showed a good agreement between INR values obtained with the automated coagulometer and the CoaguChek XS Plus. The Passing and Bablok test showed no significant deviation from linearity. The total median waiting time was 3 hours and 45 minutes (from 0:44 to 6:05) and 1 hour and 16 minutes (P < 0.001) during standard monitoring and the use of the CoaguChek XS Plus, respectively. CoaguChek XS Plus is a suitable POCT for monitoring VKA therapy at a thrombosis centre, thus significantly reducing the time spent by patients for blood sampling and waiting for dosage adjustment.
{"title":"Points of Care Testing International Normalized Ratio: Are They Useful for Monitoring Vitamin K Antagonists in a Thrombosis Center?","authors":"D. Barcellona, L. Fenu, F. Marongiu","doi":"10.1097/POC.0000000000000159","DOIUrl":"https://doi.org/10.1097/POC.0000000000000159","url":null,"abstract":"Abstract Point of care testing (POCT) international normalized ratio (INR) devices are widely accepted for self-testing and self-management of vitamin K antagonists (VKAs). The aim of this work was to evaluate the performance of a POCT at our thrombosis centre aiming at reducing the time spent by patients for blood sampling and dose adjustment. A total of 101 consecutive oral anticoagulated patients (53 M, 48 F, median age 74 years, 23–89) were enrolled in the study that consisted of 2 different phases. In the first, standard monitoring was carried out for 3 months; during this period, the INR value was also determined by capillary blood sample with the use of a POCT to compare the INR values obtained with the two systems. In the second phase, patients were monitored for 3 months using only the CoaguChek XS Plus. The Bland-Altman test showed a good agreement between INR values obtained with the automated coagulometer and the CoaguChek XS Plus. The Passing and Bablok test showed no significant deviation from linearity. The total median waiting time was 3 hours and 45 minutes (from 0:44 to 6:05) and 1 hour and 16 minutes (P < 0.001) during standard monitoring and the use of the CoaguChek XS Plus, respectively. CoaguChek XS Plus is a suitable POCT for monitoring VKA therapy at a thrombosis centre, thus significantly reducing the time spent by patients for blood sampling and waiting for dosage adjustment.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82115139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000162
M. Nouri, Elchin Barzegar, A. Ahmadi, F. Etezadi, M. Mojtahedzadeh
Background and Aims Coagulation abnormalities are relatively common among septic patients. The standard of care for preventing thrombosis in critically ill patients is subcutaneous administration of unfractionated heparin 2 or 3 times a day, which fails in some cases. We studied the influence of continuous intravenous infusion of equivalent doses on coagulation profile using rotational thromboelastometry. Subjects and Methods Patients were randomly allocated to the subcutaneous group (n = 15) or infusion group (n = 15). The subcutaneous group received 5000 units 3 times a day, whereas the infusion group received heparin 500 units/hour intravenously. Results Clotting times were significantly lower in the infusion group compared with the subcutaneous group on days 2 and 7 (P < 0.05). Clot formation times were also significantly lower in the infusion group both on days 2 and 7 (P < 0.05). Conclusions Intravenous infusion of low-dose heparin might provide more efficient thromboprophylaxis in septic patients. This method could be used in those who are at higher risk of thrombosis.
{"title":"Differentiating the Effects of Prophylactic Unfractionated Heparin Infusion by Rotational Thromboelastometry in Sepsis","authors":"M. Nouri, Elchin Barzegar, A. Ahmadi, F. Etezadi, M. Mojtahedzadeh","doi":"10.1097/POC.0000000000000162","DOIUrl":"https://doi.org/10.1097/POC.0000000000000162","url":null,"abstract":"Background and Aims Coagulation abnormalities are relatively common among septic patients. The standard of care for preventing thrombosis in critically ill patients is subcutaneous administration of unfractionated heparin 2 or 3 times a day, which fails in some cases. We studied the influence of continuous intravenous infusion of equivalent doses on coagulation profile using rotational thromboelastometry. Subjects and Methods Patients were randomly allocated to the subcutaneous group (n = 15) or infusion group (n = 15). The subcutaneous group received 5000 units 3 times a day, whereas the infusion group received heparin 500 units/hour intravenously. Results Clotting times were significantly lower in the infusion group compared with the subcutaneous group on days 2 and 7 (P < 0.05). Clot formation times were also significantly lower in the infusion group both on days 2 and 7 (P < 0.05). Conclusions Intravenous infusion of low-dose heparin might provide more efficient thromboprophylaxis in septic patients. This method could be used in those who are at higher risk of thrombosis.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84453580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000165
Steven Valorz
{"title":"Invited Product Profile Alere RALS Connectivity for Point-of-Care Testing","authors":"Steven Valorz","doi":"10.1097/POC.0000000000000165","DOIUrl":"https://doi.org/10.1097/POC.0000000000000165","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88171327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000166
Qinwei Shi, Duane Poorman, K. Clark
Abstract Although many qualitative point-of-care tests are commercially available for detection of pregnancy including urine and serum human chorionic gonadotropin (hCG) tests, these products are often associated with higher risk of false-negative results and are not easy to use. The ADEXUSDx hCG Test uses only 1 drop (35–40 &mgr;L) of whole blood sample for the detection of hCG, making it suitable for capillary blood testing. Comparison with Access Total &bgr;hCG (5th IS) assay using 392 finger stick samples from women of child-bearing age demonstrated an overall agreement of 98.1%. Performance of the ADEXUSDx hCG Test was prospectively evaluated in 40 pregnant and 40 nonpregnant women aged 18 to 44 years. The hCG test generated 100% sensitivity and 100% specificity. Study of additional 318 nonpregnant women in various age groups demonstrated 99.7% specificity. The ADEXUSDx hCG Test is a rapid test (10 minutes) with demonstrated ease of use and clinical performance, making it a useful point-of-care test as well as over-the-counter test.
虽然许多定性的即时检测方法在商业上可用于妊娠检测，包括尿液和血清人绒毛膜促性腺激素(hCG)检测，但这些产品往往与假阴性结果的高风险相关，而且不容易使用。ADEXUSDx hCG检测只需要1滴(35-40 μ L)全血样本检测hCG，适用于毛细管血液检测。与使用来自育龄妇女的392个手指棒样本的Access Total &bgr;hCG (5th IS)检测相比，结果总体一致性为98.1%。对40名18至44岁的孕妇和40名非孕妇进行ADEXUSDx hCG测试。hCG测试产生100%的敏感性和100%的特异性。另外318名不同年龄组的未怀孕妇女的研究显示出99.7%的特异性。ADEXUSDx hCG测试是一种快速测试(10分钟)，证明易于使用和临床性能，使其成为一种有用的护理点测试以及非处方测试。
{"title":"Invited Product Profile ADEXUSDx hCG Capillary Blood Test","authors":"Qinwei Shi, Duane Poorman, K. Clark","doi":"10.1097/POC.0000000000000166","DOIUrl":"https://doi.org/10.1097/POC.0000000000000166","url":null,"abstract":"Abstract Although many qualitative point-of-care tests are commercially available for detection of pregnancy including urine and serum human chorionic gonadotropin (hCG) tests, these products are often associated with higher risk of false-negative results and are not easy to use. The ADEXUSDx hCG Test uses only 1 drop (35–40 &mgr;L) of whole blood sample for the detection of hCG, making it suitable for capillary blood testing. Comparison with Access Total &bgr;hCG (5th IS) assay using 392 finger stick samples from women of child-bearing age demonstrated an overall agreement of 98.1%. Performance of the ADEXUSDx hCG Test was prospectively evaluated in 40 pregnant and 40 nonpregnant women aged 18 to 44 years. The hCG test generated 100% sensitivity and 100% specificity. Study of additional 318 nonpregnant women in various age groups demonstrated 99.7% specificity. The ADEXUSDx hCG Test is a rapid test (10 minutes) with demonstrated ease of use and clinical performance, making it a useful point-of-care test as well as over-the-counter test.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74858652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000163
Mikael Söderqvist, J. Virta, A. Kämäräinen
Abstract Diagnosing illicit substance and drug intoxications in prehospital setting may be difficult. Invasive treatment procedures might be avoided with substance specific antidote treatment. An oral fluid (OF) screening device may aid differential diagnostics in the care of a patient suffering from an unknown intoxication or unconsciousness. The aim of this study was to evaluate whether on-site OF screening improves the diagnosis and treatment of emergency medical service (EMS) patients with lowered level of consciousness due to suspected intoxication or an unknown cause. A retrospective analysis was conducted on patients who were treated by a mobile intensive care unit due to a lowered level of consciousness and tested with an OF screening device. Patient characteristics, the cause of EMS activation, and screening test results were recorded from EMS run sheets, hospital medical records, and laboratory data. Prehospital treatment was evaluated in regard to the OF screening result. A total of 57 patients were tested during the study period. Of these, 8 were excluded owing to missing screening results. Of the final 49 patients (35 males, 14 females), 16 patients (33%) tested positive for one or more substances. In 6 (38%) of the 16 patients, treatment was modified based on the screening results, and in 4 of these cases, there was a clinically relevant prehospital response. Oral fluid screening for illicit substances can be a valuable diagnostic tool in addition to the usual diagnostic methods in EMS patients with unconsciousness due to an unknown cause or intoxication.
{"title":"Substance Abuse Among Emergency Medical Service Patients: A Pilot Study on the Clinical Impact of an On-site Oral Fluid Screening Test","authors":"Mikael Söderqvist, J. Virta, A. Kämäräinen","doi":"10.1097/POC.0000000000000163","DOIUrl":"https://doi.org/10.1097/POC.0000000000000163","url":null,"abstract":"Abstract Diagnosing illicit substance and drug intoxications in prehospital setting may be difficult. Invasive treatment procedures might be avoided with substance specific antidote treatment. An oral fluid (OF) screening device may aid differential diagnostics in the care of a patient suffering from an unknown intoxication or unconsciousness. The aim of this study was to evaluate whether on-site OF screening improves the diagnosis and treatment of emergency medical service (EMS) patients with lowered level of consciousness due to suspected intoxication or an unknown cause. A retrospective analysis was conducted on patients who were treated by a mobile intensive care unit due to a lowered level of consciousness and tested with an OF screening device. Patient characteristics, the cause of EMS activation, and screening test results were recorded from EMS run sheets, hospital medical records, and laboratory data. Prehospital treatment was evaluated in regard to the OF screening result. A total of 57 patients were tested during the study period. Of these, 8 were excluded owing to missing screening results. Of the final 49 patients (35 males, 14 females), 16 patients (33%) tested positive for one or more substances. In 6 (38%) of the 16 patients, treatment was modified based on the screening results, and in 4 of these cases, there was a clinically relevant prehospital response. Oral fluid screening for illicit substances can be a valuable diagnostic tool in addition to the usual diagnostic methods in EMS patients with unconsciousness due to an unknown cause or intoxication.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91400630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-01DOI: 10.1097/POC.0000000000000161
Emily J. Christenberry, Margie E. Padilla, M. Aguirre, Amanda Loya, Lorenzo Aragón
Abstract A recent increase in the number of point-of-care (POC) international normalized ratio (INR) measurements greater than 4 and the need for venous confirmatory testing in an academic family medicine clinic has led to the further exploration of the accuracy of POC INRs greater than 4. The primary objective of this quality improvement project was to compare the POC INR measurements with confirmatory venipuncture INR measurements. Seventeen patients representing 41 separate encounters over a 20-month period were retrospectively reviewed. The median POC INR was 4.5 (interquartile range, 4.1 to 5.1) versus a median venous INR of 3.4 (interquartile range, 3 to 3.9) of the 27 patient encounters where a venous INR was available. This difference between POC and venous INR resulted in a change in therapy for over 80% of the patients, which is a higher-than-reported discrepancy between POC INRs and venous INRs in patients with a POC INR greater than 4. Clinicians using the results of these POC devices who are unaware of the potential positive bias in POC INR values compared with venous draw values are at risk for making warfarin dose reductions, which can put their patients at risk for thromboembolic events.
{"title":"Reliability of Point-of-Care International Normalized Ratio Testing in an Academic Family Medicine Clinic","authors":"Emily J. Christenberry, Margie E. Padilla, M. Aguirre, Amanda Loya, Lorenzo Aragón","doi":"10.1097/POC.0000000000000161","DOIUrl":"https://doi.org/10.1097/POC.0000000000000161","url":null,"abstract":"Abstract A recent increase in the number of point-of-care (POC) international normalized ratio (INR) measurements greater than 4 and the need for venous confirmatory testing in an academic family medicine clinic has led to the further exploration of the accuracy of POC INRs greater than 4. The primary objective of this quality improvement project was to compare the POC INR measurements with confirmatory venipuncture INR measurements. Seventeen patients representing 41 separate encounters over a 20-month period were retrospectively reviewed. The median POC INR was 4.5 (interquartile range, 4.1 to 5.1) versus a median venous INR of 3.4 (interquartile range, 3 to 3.9) of the 27 patient encounters where a venous INR was available. This difference between POC and venous INR resulted in a change in therapy for over 80% of the patients, which is a higher-than-reported discrepancy between POC INRs and venous INRs in patients with a POC INR greater than 4. Clinicians using the results of these POC devices who are unaware of the potential positive bias in POC INR values compared with venous draw values are at risk for making warfarin dose reductions, which can put their patients at risk for thromboembolic events.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84454227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-08DOI: 10.1097/POC.0000000000000173
G. Dimeski, O. Treacy
Objectives The objectives of this study were to demonstrate the effect of albumin and pH on total and ionized calcium (TCa, iCa) and total and ionized magnesium (TMg, iMg) in a tertiary level hospital. The ionized fraction was tested on 2 different blood gas analyzers (Nova Prime Plus and Siemens RapidPoint 500), whereas iMg was only available on the Prime Plus. Methods The study consisted of 3 parts. Part 1 was to investigate the effects of increasing albumin by using a pooled serum sample and then spiking aliquots with Albumix to provide a wide concentration range. Part 2 investigated the effects of pH in fresh whole blood and pooled serum by spiking the aliquots with sodium hydroxide (NaOH) or hydrochloric acid (HCl) to provide a wide concentration range. The final part was to determine the percentage range of the ionized fractions in normal samples. Results Total calcium and iCa decreased by 0.01 mmol/L per 1 g/L with increasing albumin at a similar rate in response to increasing albumin concentration. Total magnesium and iMg also decreased but to a lesser degree by 0.003 and 0.005 mmol/L, respectively. As the pH increased, iCa decreased by approximately 0.04 mmol/L per 0.1 pH units in both sample types. The iMg decreased at a much smaller magnitude, by 0.002 mmol/L in whole blood and 0.001 mmol/L in serum per 0.1 pH unit. The ionized fraction percentages in the normal samples were as follows: iCa, 51% (44–57), and iMg, 69% (61–77). Conclusions The iCa and iMg should be routinely measured, owing to their clear inverse relationship with albumin and pH. Routine measurement of the ionized fractions would avoid the need for correction factors and would highlight the physiologically active ion concentration for better patient care decisions.
{"title":"The Influence of Albumin and pH on Total and Ionized Calcium and Magnesium","authors":"G. Dimeski, O. Treacy","doi":"10.1097/POC.0000000000000173","DOIUrl":"https://doi.org/10.1097/POC.0000000000000173","url":null,"abstract":"Objectives The objectives of this study were to demonstrate the effect of albumin and pH on total and ionized calcium (TCa, iCa) and total and ionized magnesium (TMg, iMg) in a tertiary level hospital. The ionized fraction was tested on 2 different blood gas analyzers (Nova Prime Plus and Siemens RapidPoint 500), whereas iMg was only available on the Prime Plus. Methods The study consisted of 3 parts. Part 1 was to investigate the effects of increasing albumin by using a pooled serum sample and then spiking aliquots with Albumix to provide a wide concentration range. Part 2 investigated the effects of pH in fresh whole blood and pooled serum by spiking the aliquots with sodium hydroxide (NaOH) or hydrochloric acid (HCl) to provide a wide concentration range. The final part was to determine the percentage range of the ionized fractions in normal samples. Results Total calcium and iCa decreased by 0.01 mmol/L per 1 g/L with increasing albumin at a similar rate in response to increasing albumin concentration. Total magnesium and iMg also decreased but to a lesser degree by 0.003 and 0.005 mmol/L, respectively. As the pH increased, iCa decreased by approximately 0.04 mmol/L per 0.1 pH units in both sample types. The iMg decreased at a much smaller magnitude, by 0.002 mmol/L in whole blood and 0.001 mmol/L in serum per 0.1 pH unit. The ionized fraction percentages in the normal samples were as follows: iCa, 51% (44–57), and iMg, 69% (61–77). Conclusions The iCa and iMg should be routinely measured, owing to their clear inverse relationship with albumin and pH. Routine measurement of the ionized fractions would avoid the need for correction factors and would highlight the physiologically active ion concentration for better patient care decisions.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74086410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-01DOI: 10.1097/POC.0000000000000153
K. Crawford, E. Sotiridou, K. Beardsall
H ypoglycemia (blood glucose [BG], <2.6 mmol/L) is common in neonates during the first week of life. Although this may be physiologically normal, hypoglycemia can be pathological leading to neurological impairment. All infants therefore considered at risk for hypoglycemia undergo BG monitoring after birth. However, identifying those actually at risk from lowBG levels due to impaired counter regulation is challenging. Medical interventions need to balance the risks from hypoglycemia with the potential harm from medical interventions and the need to separate mother and baby. Development of point-of-care (POC) technology that measures alternative fuels (ketones and lactate) could provide the means to identify those infants at significant risk, while avoiding unnecessary separation.
{"title":"Feasibility of the Use of Point-of-Care Technology to Measure Ketone and Lactate Levels in the Newborn at Risk for Hypoglycemia","authors":"K. Crawford, E. Sotiridou, K. Beardsall","doi":"10.1097/POC.0000000000000153","DOIUrl":"https://doi.org/10.1097/POC.0000000000000153","url":null,"abstract":"H ypoglycemia (blood glucose [BG], <2.6 mmol/L) is common in neonates during the first week of life. Although this may be physiologically normal, hypoglycemia can be pathological leading to neurological impairment. All infants therefore considered at risk for hypoglycemia undergo BG monitoring after birth. However, identifying those actually at risk from lowBG levels due to impaired counter regulation is challenging. Medical interventions need to balance the risks from hypoglycemia with the potential harm from medical interventions and the need to separate mother and baby. Development of point-of-care (POC) technology that measures alternative fuels (ketones and lactate) could provide the means to identify those infants at significant risk, while avoiding unnecessary separation.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73397061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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