RT Book, Section
A1 Manasia, Anthony
A1 Narimasu, Jon
A2 Oropello, John M.
A2 Pastores, Stephen M.
A2 Kvetan, Vladimir
SR Print(0)
ID 1136412810
T1 Biomarkers in Decision Making
T2 Critical Care
YR 1
FD 1
PB McGraw-Hill Education
PP New York, NY
SN 9780071820813
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1136412810
RD 2024/04/24
AB KEY  POINTSAn  ideal  biomarker  has  a  high  sensitivity  and  allows  for  clinical  applications  in  the  diagnosis,  staging,  prognosis,  and  treatment  of  disease.Early  identification  of  ischemia  after  the  rupture  or  erosion  of  an  atherosclerotic  coronary  plaque  and  before  myonecrosis  occurs  is  currently  under  investigation.  Biomarkers  of  myocardial  ischemia  include  choline,  a  chemical  released  during  membrane  damage;  unbound  free  fatty  acids,  a  chemical  released  by  ischemic  myocytes  and  ischemia-modified  albumin.The  cardiac  biomarkers  B-type  natriuretic  peptide  (BNP)  and  N-terminal  proBNP  (NT-proBNP)  are  elevated  in  80%  of  patients  who  present  to  the  emergency  department  (ED)  with  chronic  heart  failure  (CHF).Neutrophil  gelatinase-associated  lipocalin  (NGAL)  is  a  novel  serum  biomarker  that  can  identify  acute  kidney  injury  (AKI)  early  after  the  initial  renal  insult  and  can  be  reliably  measured  in  the  plasma  by  point-of-care  immunoassay.  NGAL  levels  were  elevated  up  to  48  hours  prior  to  the  diagnosis  of  AKI  based  on  the  risk  or  renal  dysfunction,  injury  to  the  kidney,  failure  of  kidney  function,  loss  of  kidney  function,  and  end-stage  kidney  disease  (RIFLE)  criteria  in  a  recent  study.The  use  of  procalcitonin  (PCT)  in  the  diagnosis  and  discrimination  of  bacterial  infection,  sepsis,  and  response  to  antibiotic  therapy  from  noninfectious  causes  of  systemic  inflammatory  response  syndrome  (SIRS)  (ie,  pancreatitis)  is  currently  in  use  by  some  institutions.