Bedside analysis

Dry chemistry intends to fill these gaps. Bedside-analysis , Nearer to the patients and Real-time analysis are some of the terms used to describe this technology. This means closeness to the patients, i.e. analysis advances into hospital rooms, doctor s practices and even into the patients hands. Dry chemistry has been called the wonder weapon, dreams of the future, or even revolutionary. Surely, these expressions, mainly used in compilations, go too far. 

Immunosensors promise to become principal players ia chemical, diagnostic, and environmental analyses by the latter 1990s. Given the practical limits of immunosensors (low ppb or ng/mL to mid-pptr or pg/mL) and their portabiUty, the primary appHcation is expected to be as rapid screening devices ia noncentralized clinical laboratories, ia iatensive care faciUties, and as bedside monitors, ia physicians offices, and ia environmental and iadustrial settings (49—52). Industrial appHcations for immunosensors will also include use as the basis for automated on-line or flow-injection analysis systems to analyze and control pharmaceutical, food, and chemical processing lines (53). Immunosensors are not expected to replace laboratory-based immunoassays, but to open up new appHcations for immunoassay-based technology. 

Stahl N, Mellergard P, Hallstrom A, Ungerstedt U, Nordstrom CH. 2001a. Intracerebral microdialysis and bedside biochemical analysis in patients with fatal traumatic brain lesions. Acta Anaesthesiol Scand 45(8) 977-985. 

Elizabeth Barrett Browning after hearing a discussion of toxicity prediction, How can I kill thee, let me count the ways . A recent article by Stouch et al. [74] presents a thoughtful analysis of the validation effort for four such ADME/Tox models. Oprea et al. [75, 76[ have compared drugs leads with compounds in development and in the marketplace and shown that compounds increase in molecular weight and logP as they progress to the bedside. In silico approaches certainly have their place in the pharmaceutical industry as one more tool to increase the probability of success [77]. 

Bergveld, P., Bedside clinical chemistry from catheter tip sensor chips towards micro total analysis systems. Biomed. Microdevices 2000, 2(3), 185-195. 

Jones B, Bachner P. Q-Probe-Bedside glucose monitoring data analysis and critique. Northfield, IL, College of American Pathologists, 1991 5-15,... 

Concerning the preanalytics that have to be used, two main concepts are available for the application of enzyme electrodes to different fields of analysis. Clinical chemists nowadays are interested in autoanalyzers characterized by high measuring frequency as well as in portable bedside-type analytical systems with extremely short lag time between sample withdrawal and analysis result. On the other hand the optimal control of food production as well as bioprocesses requires the analysis of the substances of interest in a continuous or quasicontinuous way. Therefore, enzyme-electrode-based analytical systems for the application of highly diluted as well as undiluted media have been developed and commercialized. 

There is a defined need for point-of-care analysis for certain tests, those for which results are needed quickly. For example, the length of time between symptom onset and initiation of treatment is critical for minimizing cardiac injury during a heart attack. The emergency care unit (ECU) is very dependent on quick blood test results to confirm a heart attack and render the appropriate care. Transporting samples to a laboratory to obtain results can be very inefficient. So ECUs may have a bedside enzyme analyzer requiring minimal operation. A blood sample may be inserted, a button pushed, and results obtained in less than one minute. 

Applications in Clinical Analysis An example of the application of a potentiometric enzyme-based biosensor in clinical analysis is an automated monitor designed specifically to analyze blood samples at the bedside of palicnls. The i-STAT Portable Clinical Analyzer, shown in I igure 23-14a. is a handheld device capable of determining a broad range of clinically important analytes such as polas-... 

Petricoin, E.F., and Liotta, L.A., 2002, Proteomic analysis at the bedside early detection of cancer. Trends Biotechnol. 20(12 SuppI) S30-34. 

The next diagnostic steps usually include arterial gas analysis, blood electrolytes (including anion gap), serum lactate (if there is doubt about the cause of the acidemia), complete blood cell count, biochemical assessment of liver and renal fnnction, blood and nrine cnltures, myocardial biomarkers (if there is suspicion of a myocardial infarction), ECG and chest X-ray. In this context it is advantageons that most modem gas analysers also readily provide potassinm concentrations. Another recent advantage is the advent of bedside ketone body monitors. It is thus nowadays possible to have... 

An engineering approach, what might be called real systems analysis, may be a better way for scientists to identify and develop solutions for biomedical problans. This kind of problem solving requires that translational medicine research place more phasis on going from the bedside to the bench, rather than the other way around. 

At last, around 2011, the PuhnoVista 500 appeared on the market. The instrument was particularly well-adapted to he used at the bedside, and with a screen where the lung regional activity could he followed, Figure 10.14. The computer solution allowed followup and trend analysis in a simple way. Take notice that in spite of the poor image resolution, it is sufficient for answering very important clinical therapeutic questions. 

Breath alcohol analysis is also useful for diagnostic purposes especially at the emergency room. Based on bedside results of breath alcohol tests, emergency doctors can determine whether observed symptoms, signs, or injuries are drinking-related. 

A large number of enthalpimetric assays based on immobilized enzyme reactors have been proposed with potential interest to biotechnology, clinical chemistry, and food analysis. Several of these have been applied in bioprocess monitoring and recently bedside monitoring of glucose and urea have been... 

Nevertheless, no truly reliable implantable sensor has yet reached the market. In the meantime, bedside-type discrete analyzers seem to offer the most economic and reliable means for critical care. In addition, ex vivo on-line analysis based on microdialysis sampling seems to be helpful. 

L. Corvaglia, A. Aceti, V. Paoletti, E. Mariani, D. Patrono, G. Ancora, M. G. Capretti, and G. Faldella, Standard Fortification of Preterm Human Milk Fails to Meet Recommended Protein Intake Bedside Evaluation by Near-Infrared-Reflectance-Analysis, Early Hum. Dev., 86(4), 237 (2010). 

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