Point of Care Devices Troponin

Question: Discuss about thePoint of Care Devicesfor Troponin. Answer: Recommendation for Best Device for Troponin The troponin is type of protein find in cardiac muscle and it is regarded as a marker for cardiac injury or cardiac arrest. The test measure the level Of troponin T or troponin I in the blood to detect the level of damage to the heart muscle due to a heart attack[i]. The most basic criteria for the test are sample of blood and turnaround time measurement should be 1 hour. Among the five types of POCT device for troponin, Triage troponin I/Alere can be the most effective device for the test due to its cost-effectiveness and rapid testing. Alere immunoassay provides the diagnostic answer for a range of test as well as troponin I. Another advantage of this device is that its sensitivity value is high. The chromtagrphic technique used for the test gives the most effective treatment[ii]. Specimen collection is also easy which can be done by heparinised whole blood. A few precautions required for the device is that it should be protected against any microbiological hazard throughout the pr ocedure. Proper disposal of specimen is also essential. Humidity and temperature can also affect results, so that factor should also be kept in mind. Testing should be done immediately after specimen collection. The device has been compared other standard testing for troponin and the overall accuracy is almost 99%[iii]. Recommendation for Best Device for Creatinine Creatinine is a waste product in the body formed due to creatinine breakdown. The test is done to determine the level of creatinine breakdown and detect the functioning of the kidney. Normally creatinine is excreted out of the body by kidney and detection of high level of creatinine means there is defect in the function of the kidney[iv]. A number of device is available for the detection of the test. The effectiveness of device depends on its level of accuracy and the time taken to do the test. Cost effectiveness is also essential so that people get this test done on time. Among the devices mentioned in comparative study of POCT devices, ABL 800 Flex gives the result in far less time than other devices and the time is far shorter than other conventional testing models[v]. The appliances can be easily used on table top in clinical setting. The enzymatic method utilized for the test is effective as it reduces inaccuracies that are normally found in picric method. Thus this effective mo del will promote early detection and management of chronic renal failure. In a study, ABL 800 FLEX was compared with other assays in patients and it was found that that the device showed best overall concordance with plasma creatinine. The other device like Nova Stat sensor has less concordance. Hence, this device can be more reliable and applicable for detection of chronic kidney disease. In a questionnaire for patients experience with the device, the point four was received for each question on Likert scale[vi]. Reference [i] Pracon R, Kruk M, Jakubczak B, Demkow M, Bilinska ZT. Superior early diagnostic performance of a sensitive cardiac troponin assay as compared to a standard troponin test in the diagnosis of acute myocardial infarction. Kardiol Pol. 2012 Feb 17;70(2):131-8. [ii] Jenkins K, Guarner J, Brammer N, Evans C, Inman Y, Byrd J, Capes J, Bockman J, Isaac T, Copeland S, Hosier L. Verification and Implementation of a Point-of-Care Troponin Test in an Emergency Department: Successes and Challenges. American Journal of Clinical Pathology. 2015 Oct 1;144(suppl 2):A039-. [iii] Venner AA, Paluck C, Wesenberg JC. Assessment of the equivalency for Troponin I as either negative or positive by Alere Triage and Abbott i-STAT relative to Siemens Dimension Vista. Clinical Biochemistry. 2015;15(48):1010. [iv] Kalisch LM, Caughey GE, Barratt JD, Ramsay EN, Killer G, Gilbert AL, Roughead EE. Prevalence of preventable medication-related hospitalizations in Australia: an opportunity to reduce harm. International Journal for Quality in Health Care. 2012 Jun 1;24(3):239-49. [v] Petrides AK, Ness MA, Judge DP, Sokoll LJ, Marzinke MA. Fluctuating creatinine in the cardiac unit. Clinica Chimica Acta. 2015 Jul 20;447:52-4. [vi] Xu CX, Beeks O, Boone L, Chuang H, Visnick H. Development of a Stable, Multi-Use Creatinine Biosensor with Extended Use Life. InMeeting Abstracts 2014 Apr 1 (No. 26, pp. 1120-1120). The Electrochemical Society.