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Point of care lactate

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https://www.readbyqxmd.com/read/29339078/analytical-and-pre-analytical-performance-characteristics-of-a-novel-cartridge-type-blood-gas-analyzer-for-point-of-care-and-laboratory-testing
#1
Matthijs Oyaert, Tom Van Maerken, Silke Bridts, Silvi Van Loon, Heleen Laverge, Veronique Stove
BACKGROUND: Point-of-care blood gas test results may benefit therapeutic decision making by their immediate impact on patient care. We evaluated the (pre-)analytical performance of a novel cartridge-type blood gas analyzer, the GEM Premier 5000 (Werfen), for the determination of pH, partial carbon dioxide pressure (pCO2), partial oxygen pressure (pO2), sodium (Na+), potassium (K+), chloride (Cl-), ionized calcium (iCa2+), glucose, lactate, and total hemoglobin (tHb). METHODS: Total imprecision was estimated according to the CLSI EP5-A2 protocol...
January 12, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29319371/a-four-tiered-prognostic-score-for-patients-receiving-palliative-thoracic-radiotherapy-for-lung-cancer
#2
Carsten Nieder, Terje Tollåli, Ellinor Haukland, Anne Reigstad, Liv Randi Flatøy, Astrid Dalhaug
Palliative radiotherapy improves lung cancer related symptoms. Prognosis should be taken into account when deciding about fractionation. In this study, prognostic factors derived from multivariate analysis were used to assign a point sum reflecting 6-month survival. Four prognostic groups were compared. Performance status, lactate dehydrogenase, C-reactive protein, liver/adrenal gland metastases, and extrathoracic disease status significantly predicted survival and formed the basis of the score. The four groups had a median survival of 0...
January 10, 2018: Cancer Investigation
https://www.readbyqxmd.com/read/29302195/can-base-excess-and-anion-gap-predict-lactate-level-in-diagnosis-of-septic-shock
#3
Werapon Pongmanee, Veerapong Vattanavanit
Background: Lactate measurement is the key component in septic shock identification and resuscitation. However, point-of-care lactate testing is not widely used due to the lack of access to nearby test equipment. Biomarkers such as serum lactate, anion gap (AG), and base excess (BE) are used in determining shock in patients with seemingly normal vital signs. Purpose: We aimed to determine if these biomarkers can be used interchangeably in patients with septic shock in the emergency setting...
2018: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29297820/evaluation-of-health-parameters-in-cownose-rays-rhinoptera-bonasus-housed-in-a-seasonal-touch-pool-habitat-compared-with-an-off-exhibit-habitat
#4
James G Johnson, Lisa M Naples, William G Van Bonn, Angela D Kent, Mark A Mitchell, Matthew C Allender
Cownose rays ( Rhinoptera bonasus) are commonly displayed in zoo and aquarium touch pool exhibits; however, there is a gap in our understanding of how these practices might impact the health of these animals. The aim of this study was to evaluate and compare selected health parameters in cownose rays housed in a seasonal outdoor exhibit touch pool system with abundant public contact and an indoor off-exhibit holding system with minimal human contact. All animals underwent physical examination, ultrasound, cloacal wash and cytology, and blood collection for complete blood counts, point-of-care blood analysis, plasma protein electrophoresis, and plasma cholesterol electrophoresis in May and October 2014...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#5
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29279631/a-clinical-study-on-the-initial-assessment-of-arterial-lactate-and-base-deficit-as-predictors-of-outcome-in-trauma-patients
#6
Rameshbabu Homanna Javali, Prithvishree Ravindra, Akkamahadevi Patil, Madhu Srinivasarangan, Harshit Mundada, S B Adarsh, S Nisarg
Background: Trauma is a leading cause of mortality in India. Outcomes can be improved by early recognition of hemorrhagic shock and expedited management. At present, we rely on traditional vital signs, which are not sensitive measures. Point of care biochemical markers have been emerging as prognostic markers in trauma, but have not been studied in Indian setting. Aims: This study aims to study the association between arterial lactate and base deficit (BD) at emergency department (ED) admission and 24 h outcome in trauma patients at risk of hemodynamic compromise...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#7
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251715/a-retrospective-analysis-of-the-respiratory-adjusted-shock-index-rasi-to-determine-the-presence-of-occult-shock-in-trauma-patients
#8
Nicholas Caputo, James Reilly, Marc Kanter, Jason West
BACKGROUND: The shock index (SI), calculated as HR/SBP, is a simple hemodynamic marker that may be used to assess for the presence of occult shock in trauma patients. The normal range for a healthy adult patient is 0.5 to 0.7. Recently, studies have demonstrated that tachypnea is the most important predictor of cardiac arrest in hospital wards and is an important indicator of derangements across multiple organ systems. As such, we have sought to determine whether the inclusion of the patient's respiratory rate to the already existing shock index (called the Respiratory Adjusted Shock Index- RASI), calculated as HR/SBP*(RR/10), will improve the overall diagnostic accuracy of detecting patients in early occult shock...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29235484/paper-based-mos2-nanosheet-mediated-fret-aptasensor-for-rapid-malaria-diagnosis
#9
Alisha Geldert, Kenry, Chwee Teck Lim
There has been growing interest in the development of paper-based biosensors because their simplicity and low cost are attractive for point-of-care diagnosis, especially in low-resource areas. However, only a limited range of paper materials - primarily chromatography papers - have been incorporated into diagnostics thus far. Here, we investigate the performance of different types of paper in order to develop an aptamer- and MoS2 nanosheet-based sensor relying on fluorescence resonance energy transfer (FRET) to signal the presence of a target protein...
December 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29158243/point-of-care-lactate-testing-for-sepsis-at-presentation-to-health-care-a-systematic-review-of-patient-outcomes
#10
Elizabeth Morris, David McCartney, Daniel Lasserson, Ann Van den Bruel, Rebecca Fisher, Gail Hayward
BACKGROUND: Lactate is measured in hospital settings to identify patients with sepsis and severe infections, and to guide initiation of early treatment. Point-of-care technology could facilitate measurement of lactate by clinicians in the community. However, there has been little research into its utility in these environments. AIM: To investigate the effect of using point-of-care lactate at presentation to health care on mortality and other clinical outcomes, in patients presenting with acute infections...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#11
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29034303/validation-of-capillary-blood-analysis-and-capillary-testing-mode-on-the-epoc-point-of-care-system
#12
Jing Cao, Rachel Edwards, Janette Chairez, Sridevi Devaraj
BACKGROUND: Laboratory test in transport is a critical component of patient care, and capillary blood is a preferred sample type particularly in children. This study evaluated the performance of capillary blood testing on the epoc Point of Care Blood Analysis System (Alere Inc). METHODS: Ten fresh venous blood samples was tested on the epoc system under the capillary mode. Correlation with GEM 4000 (Instrumentation Laboratory) was examined for Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pO2, pCO2, and pH, and correlation with serum tested on Vitros 5600 (Ortho Clinical Diagnostics) was examined for creatinine...
December 2017: Practical Laboratory Medicine
https://www.readbyqxmd.com/read/29032164/a-portable-microfluidic-aptamer-tethered-enzyme-capture-aptec-biosensor-for-malaria-diagnosis
#13
Lewis A Fraser, Andrew B Kinghorn, Roderick M Dirkzwager, Shaolin Liang, Yee-Wai Cheung, Bryce Lim, Simon Chi-Chin Shiu, Marco S L Tang, Dean Andrew, Joseph Manitta, Jack S Richards, Julian A Tanner
There is a critical need for better biosensors for the detection and diagnosis of malaria. We previously developed a DNA aptamer that recognises the Plasmodium falciparum lactate dehydrogenase (PfLDH) enzyme with high sensitivity and specificity. The aptamer was integrated into an Aptamer-Tethered Enzyme Capture (APTEC) assay as a laboratory-based diagnostic approach. However, a portable equipment-free point-of-care aptamer-mediated biosensor could have a significant impact on malaria diagnosis in endemic regions...
October 4, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28986863/prognostic-implications-of-blood-lactate-concentrations-after-cardiac-arrest-a-retrospective-study
#14
Antonio Maria Dell'Anna, Claudio Sandroni, Irene Lamanna, Ilaria Belloni, Katia Donadello, Jacques Creteur, Jean-Louis Vincent, Fabio Silvio Taccone
BACKGROUND: Elevated lactate concentration has been associated with increased mortality after out-of-hospital cardiac arrest (CA). We investigated the variables associated with high blood lactate concentrations and explored the relationship between blood lactate and neurological outcome in this setting. METHODS: This was a retrospective analysis of an institutional database that included all adult (> 18 years) patients admitted to a multidisciplinary Department of Intensive Care between January 2009 and January 2013 after resuscitation from CA...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28972955/impaired-cerebellar-maturation-growth-restriction-and-circulating-insulin-like-growth-factor-1-in-preterm-rabbit-pups
#15
Kristbjörg Sveinsdóttir, John-Kalle Länsberg, Snjólaug Sveinsdóttir, Martin Garwicz, Lennart Ohlsson, Ann Hellström, Lois Smith, Magnus Gram, David Ley
Cerebellar growth is impeded following very preterm birth in human infants and the observed reduction in cerebellar volume is associated with neurodevelopmental impairment. Decreased levels of circulating insulin-like growth factor 1 (IGF-1) are associated with decreased cerebellar volume. The relationship between preterm birth, circulating IGF-1, and key cell populations supporting cerebellar proliferation is unknown. The aim of this study was to evaluate the effect of preterm birth on postnatal growth, circulating IGF-1, and cerebellar maturation in a preterm rabbit pup model...
October 4, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#16
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28954004/independent-early-predictors-of-mortality-in-polytrauma-patients-a-prospective-observational-longitudinal-study
#17
Luiz Guilherme V da Costa, Maria José C Carmona, Luiz M Malbouisson, Sandro Rizoli, Joel Avancini Rocha-Filho, Ricardo Galesso Cardoso, José Otávio C Auler-Junior
OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population...
August 2017: Clinics
https://www.readbyqxmd.com/read/28950786/the-influence-of-a-change-in-septic-shock-definitions-on-intensive-care-epidemiology-and-outcome-comparison-of-sepsis-2-and-sepsis-3-definitions
#18
Rob G H Driessen, Marcel C G van de Poll, Marianne F Mol, Walther N K A van Mook, Ronny M Schnabel
BACKGROUND: Clear definitions for septic shock assist clinicians regarding recognition, treatment and standardized reporting of characteristics and outcome of this entity. Sepsis-3 definition of septic shock incorporates a new criterion, a lactate level >2 mmol/L. Differences in epidemiology and outcome of septic shock based upon both definitions were studied in an intensive care (ICU) population of septic patients. METHODS: We analyzed a prospectively collected cohort of data in the ICU of the Maastricht University Medical Centre...
September 26, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28948337/blood-versus-crystalloid-cardioplegia-in-pediatric-cardiac-surgery-a-systematic-review-and-meta-analysis
#19
REVIEW
Konstantinos S Mylonas, Aspasia Tzani, Panagiotis Metaxas, Dimitrios Schizas, Vasileios Boikou, Konstantinos P Economopoulos
The benefit of blood cardioplegia (BCP) compared to crystalloid cardioplegia (CCP) is still debatable. Our aim was to systematically review and synthesize all available evidence on the use of BCP and CCP to assess if any modality provides superior outcomes in pediatric cardiac surgery. A systematic literature search of the PubMed and Cochrane databases was performed with respect to the PRISMA statement (end-of-search date: January 30th, 2017). We extracted data on study design, demographics, cardioplegia regimens, and perioperative outcomes as well as relevant biochemical markers, namely cardiac troponin I (cTnI), lactate, and ATP levels at baseline, after reperfusion and postoperatively at 1, 4, 12, and 24 h as applicable...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#20
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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