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一种带有非固定化酶的便携式血乳酸传感器,用于早期脓毒症诊断。

A portable blood lactate sensor with a non-immobilized enzyme for early sepsis diagnosis.

机构信息

Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Pathumwan, Bangkok 10330, Thailand.

Center of Excellence in Critical Care Nephrology, Chulalongkorn University, Thailand.

出版信息

Analyst. 2022 Jun 13;147(12):2819-2827. doi: 10.1039/d2an00218c.

Abstract

Early determination of blood lactate levels may accelerate the detection of sepsis, one of the most time-sensitive illnesses. We developed and validated a portable blood lactate detection kit for clinical screening that can measure early bedside lactate levels in intensive care unit (ICU) patients suspected of having sepsis. A TiO sol-G nanocomposite was prepared and coated on a screen-printed carbon electrode (SPCE) integrated with non-immobilized lactate oxidase (LOx) to produce a novel lactate biosensor with high sensitivity and high storage stability for human blood lactate measurement. The detection kit was based on an electrochemical technique and showed a wide linear range of 1-20 mM ( = 0.9937) with a low detection limit of 0.2 mM for lactate detection. This allowed for differentiating patient groups who may have sepsis using a cut-off level of 4 mM. The device was successfully implemented for blood lactate determination in critical patients, showing an accuracy range from 75% to 112%. This device provided high-precision and rapid quantitative information validated using a blood gas analyzer. Our detection kit might help to reduce the morbidity and mortality rates in severe sepsis and septic shock patients in community hospitals.

摘要

早期测定血乳酸水平可能会加速脓毒症的检测,脓毒症是最需要及时治疗的疾病之一。我们开发并验证了一种用于临床筛查的便携式血乳酸检测试剂盒,可测量疑似患有脓毒症的重症监护病房(ICU)患者的早期床边乳酸水平。制备了 TiO2溶胶-G 纳米复合材料,并将其涂覆在与非固定化乳酸氧化酶(LOx)集成的丝网印刷碳电极(SPCE)上,以生产一种新型乳酸生物传感器,该传感器具有高灵敏度和高存储稳定性,可用于人体血乳酸测量。该检测试剂盒基于电化学技术,具有 1-20 mM 的宽线性范围( = 0.9937),乳酸检测的低检测限为 0.2 mM。这使得可以使用 4 mM 的截止值来区分可能患有脓毒症的患者群体。该设备已成功用于重症患者的血乳酸测定,显示出准确度范围为 75%至 112%。该设备使用血气分析仪提供了经过验证的高精度和快速定量信息。我们的检测试剂盒可能有助于降低社区医院严重脓毒症和脓毒性休克患者的发病率和死亡率。

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