Carden Anthony J, Salcedo Edgardo S, Tran Nam K, Gross Eric, Mattice Jennifer, Shepard Jan, Galante Joseph M
Department of Surgery, Division of Trauma and Acute Care Surgery, UC Davis Medical Center, Sacramento, California, USA.
Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, California, USA.
Trauma Surg Acute Care Open. 2016 Jul 12;1(1):e000014. doi: 10.1136/tsaco-2016-000014. eCollection 2016.
Patients with trauma are at risk for renal dysfunction from hypovolemia or urological injury. In austere environments, creatinine values are not available to guide resuscitation. A new portable device, the Stat Sensor Point-of-care (POC) Whole Blood Creatinine Analyzer, provides accurate results in <30 s and requires minimal training. This device has not been evaluated in trauma despite the theoretical benefit it provides. The purpose of this study is to determine the clinical impact of the POC device in trauma.
40 patients with trauma were enrolled in a prospective observational study. One drop of blood was used for creatinine determination on the Statsensor POC device. POC creatinine results were compared to the laboratory. Turnaround time (TAT) for POC and laboratory methods was calculated as well as time elapsed to CT scan if applicable.
Patients (n=40) were enrolled between December 2014 and March 2015. POC creatinine values were similar to laboratory methods with a mean bias of 0.075±0.27 (p=0.08). Mean analytical TATs for the POC measurements were significantly faster than the laboratory method (11.6±10.0 min vs 78.1±27.9 min, n=40, p<0.0001). Mean elapsed time before arrival at the CT scanner was 52.9±34.2 min.
The POC device reported similar creatinine values to the laboratory and provided significantly faster results. POC creatinine testing is a promising development for trauma practice in austere environments and workup of a subset of stable patients with trauma. Further study is warranted to determine clinical impact, both in hospital-based trauma and austere environments.
创伤患者因低血容量或泌尿系统损伤有发生肾功能障碍的风险。在资源匮乏的环境中，无法获得肌酐值来指导复苏。一种新型便携式设备，即Stat Sensor即时检验（POC）全血肌酐分析仪，能在30秒内提供准确结果，且只需极少培训。尽管该设备具有理论上的优势，但尚未在创伤患者中进行评估。本研究的目的是确定该POC设备对创伤患者的临床影响。
40例创伤患者纳入一项前瞻性观察性研究。用一滴血在Stat Sensor POC设备上测定肌酐。将POC肌酐结果与实验室结果进行比较。计算POC和实验室方法的周转时间（TAT），以及适用时至CT扫描的 elapsed time（此处elapsed time未明确给出准确中文释义，暂保留英文）。
2014年12月至2015年3月纳入患者（n = 40）。POC肌酐值与实验室方法相似，平均偏差为0.075±0.27（p = 0.08）。POC测量的平均分析TAT明显快于实验室方法（11.6±10.0分钟对78.1±27.9分钟，n = 40，p < 0.0001）。到达CT扫描仪前的平均elapsed time为52.9±34.2分钟。
POC设备报告的肌酐值与实验室相似，且结果显著更快。POC肌酐检测对于资源匮乏环境中的创伤实践以及部分稳定创伤患者的检查是一项有前景的进展。有必要进一步研究以确定其在医院创伤和资源匮乏环境中的临床影响。
