Hospital Laboratories

Procalcitonin and sepsis in critically ill patients

Sepsis is defined by the Sepsis-3 consensus as life-threatening organ dysfunction caused by a dysregulated host response to infection. Each hour of delay in diagnosis, attributable to failure to recognize it during patient admission, is associated with a 7% reduction in survival.

The need for early diagnosis has led to the search for a specific biomarker, which also allows risk stratification and prognosis and whose variation allows monitoring of subsequent evaluation. Procalcitonin (PCT) has revolutionized the management of sepsis, allowing a more accurate diagnosis and more efficient antibiotic management. This approach, combined with clinical strategies and the role of the laboratory, has significantly improved patient care.

The determination of PCT helps predicting bacterial infection, distinguishing it from viral infections and other inflammatory processes, and to differentiate between localized and systemic bacterial infection. It should not be used in isolation, but in combination with clinical evaluation and other microbiological data to make therapeutic decisions.

Point of care testing (POCT),generalities and challenges of accreditation

Over the last few years POCT tests have emerged as a crucial tool in the field of medical care allowing the obtaining of fast and accurate results, which accelerates the process of diagnosis, follow-up and treatment, thus improving efficiency and the quality of medical care. At Catlab we share our experience in the accreditation of POCT gasometers, through which we demonstrated that the work is done in accordance with internationally accepted standards and that we have the required technical competence.

Study of drugs of abuse in urine in the emergency laboratory. Protocol for suspected chemical submission

In Catlab hospital emergency laboratories, drugs of abuse are analyzed in urine using a rapid lateral flow immunochromatographic screening test.

It should be noted that this test provides a qualitative preliminary analytical result and has limitations that are important to be aware of. This article summarizes the main factors that can interact with this test to produce false-positive and false-negative results as well as the cut-off points and detection window for each substance.

URGENT CARE- Use of NTproBNP on heart failure assessment

Natriuretic peptides are one of the most useful biomarkers on addressing heart failure. It is useful both for ruling out pathology due to its high negative predictive value and as a supportive diagnostic marker already included in clinical practice guidelines since 2016.

At Catlab NT-proBNP is determined, using electroquimioluminescence. Since 2008 it has been available in emergency laboratories and by the end of 2020 it is also performed at Viladecavalls central laboratory, in order to adress primary care samples,thus reaching over 17,000 total determinations in 2021.

URGENT CARE - Preeclampsia Markers

Preeclampsia is a hypertensive disorder of pregnancy, which causes an important maternal-fetal morbidity and mortality, which affects 2-8% of pregnancies. In recent years, numerous studies have attempted to determine markers of Predicting the risk of preeclampsia, identifying the women with greater risk, and creating strategies to reduce its prevalence. In Catlab we have started using the sFlt-1 / PlGF ratio as a marker of preeclampsia.

URGENT CARE - Blood gases.

The measurement of the magnitudes related to the pH and the partial pressures of gases in blood (pO₂, pCO₂), are a essential instrument in the assessment of the critical patient in the Emergency Laboratories. The results reported have a great impact on patient care, since they can provoke immediate therapeutic actions. Therefore, the reliability of the report of a gasometry is fundamental, and it is necessary to control all possible sources of error, since the medical staff requests the test, the nurses performs the sampling and laboratory personnel process it .

URGENT CARE - Hemolysis index calculation. Applications in Catlab

One of the clinical laboratory objectives is to inform biological values with high accuracy. Therefore, it must be guaranteed that samples are biological free from interference, such as hemolysis. In Catlab, rates of hemolysis informed by the manufacturer have been incorporated into computer systems laboratory, so that before an analytical result is validated, it will check whether the degree of hemolysis of the sample exceeds the threshold beyond which the result may be affected.

URGENT CARE - Management of critical values in the Emergency Laboratories

Standard UNE-EN ISO 15189:2007 indicates clearly that the laboratory must have procedures to notify a doctor or responsible for the medical care of the patient immediately when the results of the corresponding analysis are at critical intervals.

URGENT CARE - Natriuretic Peptides

Natriuretic peptides were discovered over 25 years ago. Now there are 2 of them; BNP and NT-proBNP that have begun to include in Emergency Laboratories requests; and which have meaning useful to rule out heart failure in patients with acute dyspnea and no conclusive diagnosis.

URGENT CARE - Monitoring of drug concentration in serum

The monitoring of drug therapy is an important chapter of clinical biochemistry. Only through proper monitoring can be maintained and adjusted the administration of a drug with maximum efficiency.