The sudden changes in these parameters may result in life-threatening situations hence rapid results are frequently required for effective management. Tissue oxygenation, ventilation, and acid-base status are the most important factors in the management of critically ill patients admitted in ED and ICU. Only articles in English were chosen.Īs reported by the National Committee for Clinical Laboratory Standards, arterial blood gas (ABG) analysis has a prospective influence on patient care than any other laboratory determinants.
The selection is focused on literature pertaining to the issues regarding the practicability of POCT of blood gases, electrolytes, lactates, and various POCT devices associated in existing critical care settings. This review is based on literature search using Medline/Pubmed and Embase using the key phrases “point-of-care test,” “central laboratory testing,” “electrolytes,” “blood gas analysis,” “lactate,” “emergency department,” “intensive care unit” within a period between 19. Major concerns are regarding analyzer inaccuracy, imprecision and performance (interfering substances), poorly trained non-laboratorians, high cost of tests, operator-dependent quality of testing, and difficulty in integrating test results with hospital information system (HIS).
IONIZED CALCIUM ISTAT SERIAL
Other advantages are rapid data availability, reduced preanalytic and postanalytic testing errors, self-contained and user-friendly instruments, small sample volume requirements, and frequent serial whole-blood testing. The prime advantage of POCT is reduced therapeutic turnaround time (TTAT) and shorter door-to-clinical-decision time. POCT improves patient's outcome through real-time treatment of the physiological deterioration. These situations require prompt lab results, most of which are done serially, ideally a point of care test (POCT), to meet the urgency of clinical decision and avoid subsequent damage to vital organs and systems. Most frequently, electrolytes and acid-base disorders result in difficulty in weaning patients off the ventilator, prolonged admission periods, preventable cardiac arrhythmias, and cardiac arrest. Along with various “vital signs” such as, blood pressure, heart rate and rhythm, temperature, and respiratory rate, some biochemical markers reflect these rapid changes resulting in patient's unstable physiology. These settings include intensive care units (ICU) including burn, trauma, chest pain and stroke units, operating rooms (OR), emergency department (ED), pre-hospital transport systems (ambulance). The most imperative aspect of patients in emergency and critical care settings is their dynamic physiological status with rapid deterioration that may require early diagnosis and clinical decisions to be made for better patient outcome. We infer that further comprehensive, meaningful and rigorous evaluations are required to determine outcomes which are more quantifiable, closely related to testing events and are associated with effective cost benefits. On search of literature using Medline/Pubmed and Embase using the key phrases “ppoint-of-care test,” “central laboratory testing,” “electrolytes,” “blood gas analysis,” “lactate,” “emergency department,” “intensive care unit,” we found that POCT of blood gases and selected electrolytes may not entirely replace centralized laboratory testing but may transfigure the clinical practice paradigm of emergency and critical care physicians. However, still there is a noticeable debate that exists among the laboratorians, clinicians, and administrators over concerns regarding analyzer inaccuracy, imprecision and performance (interfering substances), poorly trained non-laboratorians, high cost of tests, operator-dependent quality of testing, and difficulty in integrating test results with hospital information system (HIS). Studies shows that POCT carries advantages of providing reduced therapeutic turnaround time (TTAT), shorter door-to-clinical-decision time, rapid data availability, reduced preanalytic and postanalytic testing errors, self-contained user-friendly instruments, small sample volume requirements, and frequent serial whole-blood testing. Rapid provision of blood measurements, particularly blood gases and electrolytes, may translate into improved clinical outcomes. Point-of-care testing (POCT) is one of the formidable concept introduce in the field of critical care settings to deliver decentralized, patient-centric health care to the patients.
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