Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
Integration between the Tele-Cardiology Unit and the central laboratory: methodological and clinical evaluation of point-of-care testing cardiac marker in the ambulance
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DOI：
10.1515/cclm.2006.125
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发表时间：
2006-06-01
影响因子：
6.8
通讯作者：
Pansini, Nicola
中科院分区：
文献类型：
--
作者：
Di Serio, Francesca;Lovero, Roberto;Pansini, Nicola
本研究的目的是识别救护车转运过程中院前阶段心肌坏死的患者，救护车心电图上没有 ST 段抬高 (NSTE)。评估了 i-STAT (R) 肌钙蛋白 I (cTnl) 方法的分析性能。对入院的 53 名 NSTE 救护车心电图患者进行了随访。救护车配备了实验性软件，能够从 i-STAT 设备接收数据并将其传输到受保护的地址和服务器。 cTnl平均值从2.0到34μg/L显示总CV为3.0-5.6%。检出限为0.016μg/L。 0.09 μg/L 的平均 cTnI 浓度与 8.0% 的 CV（决策极限）相关。 i-STAT cTnI 方法对于 0 至 35 μg/L 的浓度呈线性。干扰物质没有影响（p < 0.05）。对于即时检测 (POCT)，20 名 AMI 患者 (91%) 的 cTnl > 0.09 μg/L。救护车周转时间 (TAT) 中位数为 12 分钟，医院 TAT 中位数为 40 分钟，相差 28 分钟。 i-STAT cTnl 方法的高灵敏度与远程医疗程序相结合，可以在院前阶段（救护车中的早期诊断和治疗）相关的急性冠状动脉综合征患者的管理中发挥重要作用。这些方法可以改善患者的治疗结果并持续监测中心实验室的 POCT 网络，从而满足质量要求。
The aim of this study was to identify patients with myocardial necrosis in pre-hospital phase during transport by ambulance, without ST-segment elevation (NSTE) on the ambulance ECG. The analytical performance of the i-STAT (R) troponin I (cTnl) method was assessed. A total of 53 NSTE ambulance ECG patients admitted to hospital were followed. The ambulance had experimental software able to receive data from the i-STAT device and transmit it to a protected address and server. cTnl mean values from 2.0 to 34 mu g/L showed a total CV of 3.0-5.6%. The detection limit was 0.016 mu g/L. A mean cTnl concentration of 0.09 mu g/L was associated with a CV of 8.0% (decision limit). The i-STAT cTnl method was linear for concentrations from 0 to 35 mu g/L. There was no effect (p < 0.05) of interfering substances. For point-of-care testing (POCT), cTnl was > 0.09 mu g/L in 20 AMI patients (91%). The median ambulance turnaround time (TAT) was 12 min and median hospital TAT was 40 min, a difference of 28 min. The high sensitivity of the i-STAT cTnl method integrated with tele-medicine procedures could play an important role in the management of acute coronary syndrome patients related to the pre-hospital phase (early diagnosis and treatment in the ambulance). These approaches may allow improvements in patient outcomes and continuous monitoring of the POCT network in the central laboratory, thus meeting quality requirements.