A. J. Carden1, E. Salcedo1, N. Tran1, E. Gross1, J. Mattice1, J. Shepard1, J. Galante1 1University Of California – Davis,Sacramento, CA, USA
Introduction:
Trauma patients are at risk for renal dysfunction from hypovolemia or urologic injury. Contrast-induced nephropathy risk increases in those with pre-existing renal dysfunction. Laboratory plasma creatinine levels are often available only after contrast administration for imaging. Stable patients with low-energy trauma mechanisms may benefit from an algorithm for pre-contrast hydration or reduction in contrast load. Rapid point-of-care (POC) creatinine measurements may minimize delays to imaging. The purpose of this study is to determine the potential clinical impact of a new POC creatinine device in the trauma setting.
Methods:
Forty trauma patients were enrolled in a prospective observational study. One drop of blood was used for creatinine determination on a POC device (StatSensor Creatinine, Nova Biomedical, Waltham, MA). POC creatinine results were compared to the laboratory. Turnaround time (TAT) for POC and lab methods were calculated as well as time elapsed to CT scan if applicable.
Results:
Patients (n = 40) were enrolled between December 2014 and March 2015. POC creatinine values were similar to laboratory methods with a mean bias of 0.075±0.27 (p=0.08). Mean analytical TAT’s for the POC measurements were significantly faster than the laboratory method (11.6±10.0 mins vs. 78.1±27.9 mins, n = 40, p<0.0001). Mean elapsed time before arrival at the CT scanner was 52.9±34.2 mins.
Conclusion:
The POC device reported similar creatinine values to the hospital laboratory and provided significantly faster results. During this study POC testing has been successfully implemented into the standard trauma workflow. Most patients received POC creatinine values in time to affect decision-making on contrast imaging. The POC creatinine device can be implemented into the trauma algorithm to guide pre-contrast hydration or contrast load reduction in stable patients with low energy trauma mechanisms and increased risk for underlying renal dysfunction.
