Point-of-care testing (POCT) for key laboratory variables may help clinicians assess the level of acuteness and the level of care necessary in the management of deteriorating ward patients. We used a multibiomarker POCT panel including B-type natriuretic peptide (BNP), D-dimer, myoglobin (Myo), creatine kinase MB...

Reprinted from Ann Lab Med 2013 Sep; 33(5):309-18. Christenson E, Christenson RH: "The role of cardiac biomarkers in the diagnosis and management of patients presenting with suspected acute coronary syndrome". Myocardial infarction (MI) is the leading cause of death in the developed world. Biomarkers have an...

How do errors occur in the laboratory and what can we do to prevent errors? Any test can and will fail if incorrectly performed or operated under the wrong conditions. The role of the laboratory director is to determine those conditions and to understand test limitations in order to prevent laboratory errors....

Recently developed high-sensitivity cardiac troponin (cTn) assays can measure approximately 10 times lower concentrations with high precision (coefficient of variation, <10 % at the 99th percentile of the upper reference limit) than conventional assays, and can measure cTn concentrations in at least 50 % of a reference ...

Diagnosis of myocardial infarction in the absence of characteristic electrocardiographic (ECG) changes depends on measurement of circulating cardiac troponin (cTn); either cardiac troponin I (cTnI) or cardiac troponin T (cTnT).  By definition myocardial infarction is associated with increased serum cTnI and cTnT;...

Emergency Department (ED) overcrowding is becoming an increasingly international issue.  Although the problem is not only resolved by ED change management (but rather requires a system-wide solution recognizing the complex interdependencies of consumer expectations, human resources, information systems immaturity and...

Point of care (POC) testing has become an important part of nephrological care. In cases of acute renal failure, POC is indispensable in deciding the need for dialysis, but is also essential in the management of patients on regular dialysis. For example, hyperhydration, cardiovascular adverse events and inflammation...

Despite the pervasive measurement of cardiac troponin (cTn) for the diagnosis of myocardial infarction (AMI) and acute coronary syndromes (ACS), the continuous evolution of assays and guidelines for their application has created uncertainty among laboratorians and clinicians: criteria for the choice of assay and...

In the ED, 25 % of patients with angina pectoris with suspected AMI are wrongly diagnosed (no cardiac involvement). As a result, the patient risks are increased and resources are wasted. We investigated the effect of point-of-care testing (POCT) on ED processes, resource needs, patient risks and overall costs. POCT...

Emergency departments (ED) are challenged by increasing patient visits, overcrowding and prolonged length of stay (LOS). The cause of these problems is multifactorial. Delays in the laboratory are often perceived as contributing to delays in care and increased LOS. Implementation of selected point-of-care tests in...