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16 papers 25 to 100 followers Use of labs in the ED
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/24673673/procalcitonin-as-a-marker-of-serious-bacterial-infections-in-febrile-children-younger-than-3-years-old
#1
MULTICENTER STUDY
Prashant Mahajan, Mary Grzybowski, Xinguang Chen, Nirupama Kannikeswaran, Rachel Stanley, Bonita Singal, John Hoyle, Dominic Borgialli, Elizabeth Duffy, Nathan Kuppermann
OBJECTIVES: There is no perfectly sensitive or specific test for identifying young, febrile infants and children with occult serious bacterial infections (SBIs). Studies of procalcitonin (PCT), a 116-amino-acid precursor of the hormone calcitonin, have demonstrated its potential as an acute-phase biomarker for SBI. The objective of this study was to compare performance of serum PCT with traditional screening tests for detecting SBIs in young febrile infants and children. METHODS: This was a prospective, multicenter study on a convenience sample from May 2004 to December 2005...
February 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26595253/use-of-procalcitonin-assays-to-predict-serious-bacterial-infection-in-young-febrile-infants
#2
Karen Milcent, Sabine Faesch, Christèle Gras-Le Guen, François Dubos, Claire Poulalhon, Isabelle Badier, Elisabeth Marc, Christine Laguille, Loïc de Pontual, Alexis Mosca, Gisèle Nissack, Sandra Biscardi, Hélène Le Hors, Ferielle Louillet, Andreea Madalina Dumitrescu, Philippe Babe, Christelle Vauloup-Fellous, Jean Bouyer, Vincent Gajdos
IMPORTANCE: The procalcitonin (PCT) assay is an accurate screening test for identifying invasive bacterial infection (IBI); however, data on the PCT assay in very young infants are insufficient. OBJECTIVE: To assess the diagnostic characteristics of the PCT assay for detecting serious bacterial infection (SBI) and IBI in febrile infants aged 7 to 91 days. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study that included infants aged 7 to 91 days admitted for fever to 15 French pediatric emergency departments was conducted for a period of 30 months (October 1, 2008, through March 31, 2011)...
January 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/26460326/high-sensitivity-troponin-and-novel-biomarkers-for-the-early-diagnosis-of-non-st-segment-elevation-myocardial-infarction-in-patients-with-atrial-fibrillation
#3
Nils A Sörensen, Anoop Sv Shah, Francisco M Ojeda, Philipp Peitsmeyer, Tanja Zeller, Till Keller, Silke S Johannsen, Karl J Lackner, Megan Griffiths, Thomas Münzel, Nicholas L Mills, Stefan Blankenberg, Renate B Schnabel
AIMS: To evaluate the diagnostic performance of high-sensitivity troponin I (hsTnI) and other novel biomarkers for diagnosing non-ST-segment elevation myocardial infarction (NSTEMI) in patients with atrial fibrillation. METHODS: In an acute chest pain cohort (N=1673), mean age 61.4±13.6 (34% female), we measured hsTnI and 13 established and novel biomarkers reflecting ischaemia, necrosis, inflammation, myocardial stress, angiogenesis on admission and after three hours in order to investigate their diagnostic accuracy for NSTEMI...
October 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/26445673/lactate-kinetics-in-sepsis-and-septic-shock-a-review-of-the-literature-and-rationale-for-further-research
#4
REVIEW
Jason Chertoff, Michael Chisum, Bryan Garcia, Jorge Lascano
Over the last two decades, there have been vast improvements in sepsis-related outcomes, largely resulting from the widespread adoption of aggressive fluid resuscitation and infection control. With increased understanding of the pathophysiology of sepsis, novel diagnostics and resuscitative interventions are being discovered. In recent years, few diagnostic tests like lactate have engendered more attention and research in the sepsis arena. Studies highlighting lactate's prognostic potential for mortality and other outcomes are ubiquitous and largely focus on the early stage of sepsis management, defined as the initial 6 h and widely referred to as the "golden hours...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/26363848/approach-to-the-patient-with-a-negative-anion-gap
#5
Michael Emmett
When anion gap calculation generates a very small or negative number, an explanation must be sought. Sporadic (nonreproducible) measurement errors and systematic (reproducible) laboratory errors must be considered. If an error is ruled out, 2 general possibilities exist. A true anion gap reduction can be generated by either reduced concentrations of unmeasured anions such as albumin or increased concentrations of unmeasured cations such as magnesium, calcium, or lithium. This teaching case describes a patient with aspirin (salicylate) poisoning whose anion gap was markedly reduced (-47 mEq/L)...
January 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26237763/in-the-clinic-hyponatremia
#6
REVIEW
Dan A Henry
No abstract text is available yet for this article.
August 4, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/23109682/diagnostic-value-of-procalcitonin-in-well-appearing-young-febrile-infants
#7
MULTICENTER STUDY
Borja Gomez, Silvia Bressan, Santiago Mintegi, Liviana Da Dalt, Daniel Blazquez, Izaskun Olaciregui, Mercedes de la Torre, Miriam Palacios, Paola Berlese, Aitor Ruano
BACKGROUND AND OBJECTIVE: Procalcitonin (PCT) has been introduced in many European protocols for the management of febrile children. Its value among young, well-appearing infants, however, is not completely defined. Our objective was to assess its performance in diagnosing serious bacterial infections and specifically invasive bacterial infections (IBIs) in well-appearing infants aged <3 months with fever without source (FWS). METHODS: Well-appearing infants aged <3 months with FWS admitted to 7 European pediatric emergency departments were retrospectively included...
November 2012: Pediatrics
https://www.readbyqxmd.com/read/22809906/procalcitonin-usefulness-for-the-initiation-of-antibiotic-treatment-in-intensive-care-unit-patients
#8
RANDOMIZED CONTROLLED TRIAL
Nathalie Layios, Bernard Lambermont, Jean-Luc Canivet, Philippe Morimont, Jean-Charles Preiser, Christophe Garweg, Didier Ledoux, Frédéric Frippiat, Sonia Piret, Jean-Baptiste Giot, Patricia Wiesen, Christelle Meuris, Paul Massion, Philippe Leonard, Monique Nys, Patrizio Lancellotti, Jean-Paul Chapelle, Pierre Damas
OBJECTIVES: To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: Single-center, prospective, randomized controlled study. SETTING: Five intensive care units from a tertiary teaching hospital. PATIENTS: All consecutive adult patients hospitalized for >48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay...
August 2012: Critical Care Medicine
https://www.readbyqxmd.com/read/25755268/lactate-level-aetiology-and-mortality-of-adult-patients-in-an-emergency-department-a-cohort-study
#9
Mathilde Pedersen, Vibeke Schnack Brandt, Jon Gitz Holler, Annmarie Touborg Lassen
BACKGROUND: Increased lactate is associated with high mortality among patients with suspected infection or trauma in the emergency department (ED), but the association with patients with other aetiologies is less well described. The aim of this study was to describe the relation between lactate, aetiology and 7-day mortality in adult ED patients. METHODS: A retrospective cohort study of all adult patients who had a lactate measured within 4 h after arrival to the ED at Odense University Hospital between June 2012 and May 2013...
September 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/25295502/physiological-approach-to-assessment-of-acid-base-disturbances
#10
REVIEW
Kenrick Berend, Aiko P J de Vries, Rijk O B Gans
New England Journal of Medicine, Volume 371, Issue 15, Page 1434-1445, October 2014.
October 9, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/25552544/can-vbg-analysis-replace-abg-analysis-in-emergency-care
#11
REVIEW
Anne-Maree Kelly
Blood gas analysis is an integral part of the assessment of emergency department (ED) patients with acute respiratory or metabolic disease. Traditionally ABG analyses have been used, but increasingly, emergency clinicians are using venous blood gas (VBG) analyses. This has been challenged, especially by respiratory physicians, as being too inaccurate. This clinical review, using case examples, summarises the evidence supporting use of VBG to guide management decisions. Arteriovenous agreement for pH is such that values are clinically interchangeable and agreement for bicarbonate is also close...
February 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/22211091/a-randomized-clinical-trial-comparing-the-effect-of-rapidly-infused-crystalloids-on-acid-base-status-in-dehydrated-patients-in-the-emergency-department
#12
RANDOMIZED CONTROLLED TRIAL
Hakan Hasman, Orhan Cinar, Ahmet Uzun, Erdem Cevik, Loni Jay, Bilgin Comert
STUDY OBJECTIVE: To compare the effect of normal saline (NS), lactated Ringer's, and Plasmalyte on the acid-base status of dehydrated patients in the emergency department (ED). METHOD: We conducted a prospective, double-blind, randomized trial of consecutive adult patients who presented to the emergency department with moderate-severe dehydration. Patients were randomly allocated to blindly receive normal saline (NS), lactated Ringer's or Plasmalyte at 20 ml/kg/h for 2 hours...
2012: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/23903783/the-role-of-venous-blood-gas-in-the-emergency-department-a-systematic-review-and-meta-analysis
#13
REVIEW
Benjamin M Bloom, Johann Grundlingh, Jonathan P Bestwick, Tim Harris
The aim of this study is to provide a systematic review of the literature reporting agreement between arterial and venous pH, partial pressure of carbon dioxide (PCO2), bicarbonate (HCO3⁻), base excess and lactate; and to perform a meta-analysis of the differences. Medline and Embase searches using Eduserv Athens from 1950 to present were conducted using the terms 'VBG', 'ABG', 'arterial', 'venous', 'blood', 'gas', 'lactate', 'emergency' and 'department'. References of the published papers were hand searched and full-text versions of those deemed helpful to the question were obtained...
April 2014: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/24929216/comprehensive-review-on-lactate-metabolism-in-human-health
#14
REVIEW
M Adeva-Andany, M López-Ojén, R Funcasta-Calderón, E Ameneiros-Rodríguez, C Donapetry-García, M Vila-Altesor, J Rodríguez-Seijas
Metabolic pathways involved in lactate metabolism are important to understand the physiological response to exercise and the pathogenesis of prevalent diseases such as diabetes and cancer. Monocarboxylate transporters are being investigated as potential targets for diagnosis and therapy of these and other disorders. Glucose and alanine produce pyruvate which is reduced to lactate by lactate dehydrogenase in the cytoplasm without oxygen consumption. Lactate removal takes place via its oxidation to pyruvate by lactate dehydrogenase...
July 2014: Mitochondrion
https://www.readbyqxmd.com/read/23023470/procalcitonin-as-a-marker-of-bacteremia-in-children-with-fever-and-a-central-venous-catheter-presenting-to-the-emergency-department
#15
RANDOMIZED CONTROLLED TRIAL
Amanda J Kasem, Blake Bulloch, Michael Henry, Kunal Shah, Heidi Dalton
OBJECTIVE: To evaluate the clinical use of procalcitonin (PCT) as a rapid marker for the identification of bacteremia in the emergency department (ED) population of children with fever and a central venous catheter (CVC). METHODS: Children were identified on presentation to the ED with a chief complaint of fever and who had a CVC. Fever was defined as 38°C or higher orally. Patients were excluded from the study if they had received antibiotics within the previous 24 hours of presenting to the ED, if they had a peripherally inserted central catheter line or by parental refusal...
October 2012: Pediatric Emergency Care
https://www.readbyqxmd.com/read/21875776/substituting-whole-blood-for-urine-in-a-bedside-pregnancy-test
#16
COMPARATIVE STUDY
Christian Fromm, Antonios Likourezos, Lawrence Haines, Abu N G A Khan, Janet Williams, Joel Berezow
BACKGROUND: Point-of-care testing for rapid detection of pregnancy in women of reproductive age is common practice in the emergency department. Commercially available rapid human chorionic gonadotropin (hCG) immunoassays are validated for use with urine and serum, but not whole blood. STUDY OBJECTIVES: We assessed the validity of using whole blood to detect pregnancy using a point-of-care hCG assay by comparing it to a laboratory quantitative serum hCG assay as the criterion standard...
September 2012: Journal of Emergency Medicine
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