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儿科急诊中的床边动脉血气分析、电解质、乳酸及降钙素原检测

Bedside ABG, electrolytes, lactate and procalcitonin in emergency pediatrics.

作者信息

Batra Prerna, Dwivedi Ajeet Kumar, Thakur Neha

机构信息

Department of Pediatrics, University College of Medical Sciences (University of Delhi) and GTB Hospital, New Delhi, India.

Department of Pediatrics, Kalawati Saran Children Hospital, New Delhi, India.

出版信息

Int J Crit Illn Inj Sci. 2014 Jul;4(3):247-52. doi: 10.4103/2229-5151.141467.

Abstract

Point of care testing, is the term commonly applied to the bedside tests performed in sick patients. Common clinical conditions encountered in pediatric emergency rooms are respiratory, gastro-intestinal, infections and cardiac. Emergencies at most of the places, especially developing countries are overburdened. Availability of tests like arterial blood gas, lactate, electrolytes and procalcitonin, bedside tests or point of care tests can help identify sick patients quickly. Abnormalities like acid-base disturbances and dyselectrolytemias can be dealt with instantly, thus improving the overall prognosis. Lactate levels in emergency give the earliest clue to cardiovascular compromise and poor tissue perfusion. Procalcitonin has recently gained significant importance as an acute phase reactant for early identification of sepsis. Decisions for initiating or withholding antibiotic therapy can also be taken based on procalcitonin levels in emergency. Bedside estimation of serum electrolytes, blood gas analysis and procalcitonin thus facilitate the clinical evaluation and management of critical patients. An extensive literature review of current status of these investigations as point of care tests is appraised here.

摘要

即时检验是常用于对患病患者进行的床边检测的术语。儿科急诊室常见的临床病症包括呼吸系统、胃肠道、感染和心脏方面的疾病。在大多数地方,尤其是发展中国家,急诊负担过重。诸如动脉血气、乳酸、电解质和降钙素原等检测项目,床边检测或即时检验有助于快速识别患病患者。酸碱平衡紊乱和电解质异常等情况可以立即得到处理,从而改善总体预后。急诊时的乳酸水平最早提示心血管功能不全和组织灌注不良。降钙素原作为早期识别脓毒症的急性期反应物最近变得极为重要。在急诊中也可以根据降钙素原水平决定开始或停止抗生素治疗。床边血清电解质评估、血气分析和降钙素原检测有助于对危重症患者进行临床评估和管理。本文对这些作为即时检验的检测项目的现状进行了广泛的文献综述。

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