Emergency Department, Monash Health, Clayton, Victoria, Australia.
Monash Pathology, Monash Health, Clayton, Victoria, Australia.
Emerg Radiol. 2021 Feb;28(1):77-82. doi: 10.1007/s10140-020-01829-7. Epub 2020 Jul 29.
Intravenous iodinated contrast is a commonly used diagnostic aid to improve image quality on computed tomography. There exists a small risk of post-contrast acute kidney injury in patients receiving IV contrast. One of the biggest risk factors for developing PC-AKI is the presence of pre-existing renal dysfunction, making it important to measure the renal function prior to contrast administration. Point of care (POC) devices offer a quick estimation of renal function, potentially improving workflows in radiology departments.
Two POC devices were evaluated, the Nova StatSensor and Abbott iSTAT. Patients undergoing routine radiological investigations had blood collected and analysed by a POC method and the laboratory method (Beckman AU5800). The two values were analysed and compared. Renal function was calculated using eGFR via the CKD-EPI result. eGFR values were stratified as high risk (eGFR < 30), moderate risk (eGFR 30-59) and low risk (eGFR ≥ 60).
One hundred eighty-six patients were included in the study. One hundred one patients underwent the Abbott iSTAT analysis, 139 patients underwent Nova StatSensor analysis, and 53 had both. Statistical analysis revealed that the StatSensor R value was 0.77, and coefficient variation was 10.65%. iSTAT had a R value of 0.83 and coefficient variation of 7.36%. The POC devices did not miss any high-risk patients but underreported eGFR values in certain patients.
POC devices are moderately accurate at detecting renal impairment in patients undergoing radiological investigations. They seem to be a good screening tool; however, any low eGFR values should be further examined.
静脉注射碘造影剂是一种常用的诊断辅助手段，可提高计算机断层扫描的图像质量。接受静脉造影的患者存在发生对比后急性肾损伤的小风险。发生 PC-AKI 的最大风险因素之一是存在预先存在的肾功能障碍，因此在给予造影剂前测量肾功能非常重要。床边即时检测（POC）设备可快速估算肾功能，有可能改善放射科的工作流程。
评估了两种 POC 设备，即 Nova StatSensor 和 Abbott iSTAT。对接受常规放射学检查的患者采集血液，并通过 POC 方法和实验室方法（贝克曼 AU5800）进行分析。对两种方法的结果进行分析和比较。使用 CKD-EPI 结果通过 eGFR 计算肾功能。eGFR 值分层为高风险（eGFR < 30）、中风险（eGFR 30-59）和低风险（eGFR ≥ 60）。
本研究纳入了 186 名患者。101 名患者接受了 Abbott iSTAT 分析，139 名患者接受了 Nova StatSensor 分析，53 名患者同时接受了两种分析。统计分析显示 StatSensor 的 R 值为 0.77，变异系数为 10.65%。iSTAT 的 R 值为 0.83，变异系数为 7.36%。POC 设备并未遗漏任何高风险患者，但在某些患者中报告的 eGFR 值偏低。
POC 设备在检测接受放射学检查的患者的肾功能损害方面具有中等准确性。它们似乎是一种良好的筛查工具；但是，任何低 eGFR 值都应进一步检查。
