Aranke Mayank, Mian Asad I
College of Natural Sciences, University of Texas-Austin, University Station, Austin, TX.
Department of Pediatrics, Section of Emergency Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
Clin Pediatr Emerg Med. 2013 Jun;14(2):95-101. doi: 10.1016/j.cpem.2013.04.004. Epub 2013 Jun 11.
In modern pediatric emergency medicine, biomarker-based assays that enable quick bedside diagnostics and subsequent disease management can be valuable. There is a growing need for novel, disease-specific biomarkers that can improve the outcome of pediatric infectious diseases commonly encountered in the emergency department (ED). Viral respiratory infections, central nervous system infections, sepsis, and septic shock are acute disease states frequently encountered in the ED. In this review, we describe a host of novel biomarkers, including a diverse set of cytokines, chemokines, and nitric oxide-based metabolites. Based on disease pathophysiology, a rationale is provided for a molecular- or biomarker-based approach in the ED. Throughout this review, emphasis is placed on diagnostic rapidity because this relates directly to timeliness and quality of care in a busy ED. Once the biomarkers become more clinically available, in a rapid ED setting as bedside point-of-care assays, quality of care will be enhanced, not only by means of diagnostics but also in prognosticating severity of illness.
在现代儿科急诊医学中，基于生物标志物的检测方法能够实现快速床边诊断并进行后续疾病管理，具有重要价值。对于新型、疾病特异性生物标志物的需求日益增长，这些标志物能够改善急诊科（ED）常见的儿科传染病的治疗结果。病毒性呼吸道感染、中枢神经系统感染、败血症和感染性休克是急诊科经常遇到的急性疾病状态。在本综述中，我们描述了一系列新型生物标志物，包括多种细胞因子、趋化因子和基于一氧化氮的代谢产物。基于疾病病理生理学，我们为急诊科基于分子或生物标志物的方法提供了理论依据。在本综述中，重点强调了诊断的快速性，因为这直接关系到繁忙急诊科的护理及时性和质量。一旦这些生物标志物在临床上更易于获得，作为床边即时检测方法应用于快速的急诊科环境中，不仅通过诊断，而且在预测疾病严重程度方面，护理质量都将得到提高。
