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[临床前急诊医学中的即时检测]

[Point-of-care testing in preclinical emergency medicine].

作者信息

Möckel M, Searle J

机构信息

Arbeitsbereich Notfallmedizin/Rettungsstellen/CPU, Campus Virchow Klinikum und Campus Mitte, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland,

出版信息

Med Klin Intensivmed Notfmed. 2014 Mar;109(2):100-3. doi: 10.1007/s00063-013-0299-y. Epub 2014 Mar 13.

Abstract

BACKGROUND

Measurement of biological signals directly at the patient (point-of-care testing, POCT) is an established standard in emergency medicine when test results are needed quickly and within a reliable time frame or if external testing requires a disproportionate effort.

OBJECTIVES

Currently, the rapid test for β-HCG in urine and POCT measurement of lactate, blood gases, cardiac tropinin, haemoglobin, and hematocrit are well established in emergency medicine. POCT of copeptin, fatty acid-binding proteins (FABP), procalcitonin, coagulation values, natriuretic peptides, D-dimer, and toxicological substances are of future interest. In this article, the appropriate use of point-of-care testing in prehospital emergency medicine is discussed.

RESULTS

Application of POCT is dependent of the underlying conditions, the availability of appropriate devices, and of suitable reference methods in a central laboratory. In addition, economical and quality aspects play an important role.

CONCLUSION

In emergency departments, POCT is currently developing into a standard measuring method for a number of markers because hospital laboratories are increasingly being merged and consequently reduce their emergency-analytic services. In countries with a high density of hospitals, however, preclinical POCT should be reduced to the minimum necessary.

摘要

背景

当需要在快速且可靠的时间范围内获得检测结果,或者外部检测需要付出不相称的努力时,在患者处直接测量生物信号(即时检验,POCT)是急诊医学中的既定标准。

目的

目前,尿β-HCG快速检测以及乳酸、血气、心肌肌钙蛋白、血红蛋白和血细胞比容的POCT检测在急诊医学中已得到广泛应用。 copeptin、脂肪酸结合蛋白(FABP)、降钙素原、凝血值、利钠肽、D-二聚体和毒理学物质的POCT检测是未来的研究热点。本文讨论了即时检验在院前急诊医学中的合理应用。

结果

POCT的应用取决于基础条件、合适设备的可用性以及中心实验室中合适的参考方法。此外,经济和质量方面也起着重要作用。

结论

在急诊科,POCT目前正发展成为多种标志物的标准测量方法,因为医院实验室越来越多地合并,从而减少了急诊分析服务。然而,在医院密度高的国家,临床前POCT应降至必要的最低限度。

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