Discuss about the Point of Care Devices (POCT) for Creatinine and Troponin Test.
With significant advancement in health science related research, a number of technological devices are being developed, which have the health care diagnosis easier and faster. Point of care devices are becoming very useful in rapid diagnosis, as the tests are done in easy processes within very short time and the devices gives accurate results, thereby stimulating the medical interventions (5). In this assignment, the focus is to compare the point of care devices (PCOT) developed for easy diagnosis of creatinine and troponin.
Creatinine is a pivotal biomarker and it has a very important contribution in the diagnosis of kidney disease, because, due to malfunctioning of kidney, the filtration is impaired and the level of creatinine in blood increases (4). In this assignment, four point of care devices have been compared, these are i-STAT, ABL 800 Flex, Reflotron and Nova Starsensor.
i-STAT and Nova Starsensor, both are developed by USA based companies and requires whole blood as a sample, which is more available. However, ABL 800 Flex and Reflotron include whole blood, plasma or serum as sample (9). Therefore, the last two devices are more diverse, considering the sample type. In case of sample volume, ABL 800 Flex requires the highest amount, 250μl and Nova Starsensor requires the least amount, 1.2μl (6). Nova Starsensor also shows the best characteristics, based on time of sample analysis; it requires only 30 seconds showing the result. All the devices have approval from FDA. Two USA based devices are lightweight, compared to other two devices. All the devices follow enzymatic method of sample measurement. The range of detection is higher in ABL 800 Flex (10-2000 µmol/L). Except Reflotron, all three devices use Amperometric biosensor, as a method of principle; it has high sensitivity compared to Dye Reflectance. Nova Starsensor has the least weight within these four (400 gram), making it the best choice for the patient to carry the device anywhere (8). Therefore, based on the above criteria, usability and availability of sample, the Nova Starsensor is recommended as the best point of care device for creatinine test.
Troponin is a significant biomarker, which helps in diagnosis of heart attack, because, during myocardial infarction, the damaged heart muscle induces the release of this biomarker in blood, thereby elevating its level in blood. As heart attack needs immediate diagnosis, several point of care devices are used for easy and faster diagnosis, within which four devices, Triage Cardiac Panel Troponin I, i-STAT cardiac troponin I, PATHFAST troponin I and RAMP troponin I has been compared in this assignment (1).
Within the above four devices, all devices required whole blood sample, but instead of i-STAT cardiac troponin I, other devices requires heparinized or EDTA whole blood, therefore, the sample cannot be tested directly, through these devices, however, a patient undergoing a heart attack needs immediate diagnosis, thus, i-STAT cardiac troponin I would be a good choice (7). On the other hand, compared to the Triage cardiac panel troponin I, other three devices can be used in room temperature. However, the i-STAT device has the lowest weight and required the lowest volume of sample (16 μL), compared to the other three devices. The analysis time is also minimum for this device (10 minutes), within these four devices; thus, it is more user-friendly, compared to others (2). In Triage cardiac panel troponin I and RAMP troponin I, chromatography is used as the principle of method, whereas, i-STAT uses ELISA and PATHFAST troponin I uses magnetic beads. ELISA is the most relevant, hazard free and fast technique within the above three principles. Thus, based on the above comparison, i-STAT cardiac troponin I is recommended as the best point of care device for troponin test (3).
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