【体外膜肺ECMO精品课件】 Point-of-Care Testing What does is really mean today and is it relevant to the local situation.pptVIP

Point-of-Care Testing: What does is really mean today and is it relevant to the local situation ?;Point-of-Care Testing (POCT) ? the analysis of (biochemical) parameters at or near the patient’s bedside. A new name for satellite lab testing ? ER, OR, ICU Clinical benefit of POCT ? reduces the time interval between the decision to order the test and the clinical action based on the test result (total turn-around time; TAT) test needed/request ? specimen ? lab ? test/result ? report;One classification of POCT in vitro (traditional) ? manual: urinalysis, occult blood ? instrumented: glucose meters, ACT, gases in vivo ? invasive e.g. pulmonary artery catheter ? non-invasive e.g. transcutaneous bilirubin, pulse oximetry (transcutaneous) ex vivo ? in-line sensors; through an extracorporeal circuit; some examples;;;;; Monitoring anticoagulation therapy treament monitor with heparin (intrinsic pathway) ACT, aPTT coumadin/warfarin PT/INR (extrinsic pathway) direct thrombin inhibitors ??? (common pathway) Thrombolytics (clot) TT, fibrinogen;POC coagulation testing for monitoring patient status post-thoracic/cardiovascular surgery; studies have shown that this permits the evaluation and management of microvascular bleeding: ? complications - blood loss - need for blood and blood products - re-operations (repeat surgery) ? overall cost of care ? satisfaction;Patients on coumadin/warfarin therapy: Monitor using PT/INR testing Patient self-testing a major direction with clear advantages ;There are Advantages and Problems related to the use of instrumented POCT: POSITIVES ? for the most part these POCT devices are robust and easy to use; require minimal maintenance ? testing process is generally simple ? results are usually reliable;Data management in instrumented POCT systems calibration curves, AMR QC: lot information, automated QC material information: strip lot numbers, parameters identi