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P2755Effectiveness of mechanical chest compression devices in cardiac arrest: a single centre, observational, prospective study

2017; Oxford University Press; Volume: 38; Issue: suppl_1 Linguagem: Inglês

10.1093/eurheartj/ehx502.p2755

1522-9645

Nicola Gasparetto, Alessandro Daniotti, Alessandro De Leo, Silvia Orazio, Alessandro Forti, G Zilio, Vittorio Favero, Paola Martire, Diego Calzolari, Fernando Marson, V. Salandin, Paolo Rosi, Zoran Olivari,

Cardiac Arrest and Resuscitation

Background:The 2015 European Society of Cardiology guidelines propose algorithms for faster rule-in or rule-out of AMI in patients admitted in the acute care setting, and for the management of NSTEMI.Serial measurements with high sensitivity troponin I assays will more accurately and precisely measure changes in cardiac troponin I (cTnI) concentrations providing useful data to assist with identifying acute versus chronic cTnI elevations, and providing acceptable rule-in and rule-out performance within 1 to 3-hours of presentation.The performance of Siemens high sensitivity troponin I assay1 (TNIH) being developed for use on the ADVIA Centaur family of immunoassay analyzers is presented.The assay is a dual-capture sandwich immunoassay using preformed magnetic latex particles, a proprietary acridinium ester for chemiluminescence detection, and three monoclonal antibodies.Method: The assay limit of blank, LoB, and limit of detection, LoD, were determined using 3 reagent lots on 2 ADVIA Centaur XP and 2 ADVIA Centaur XPT systems, collecting 60 replicate measurements for each of 10 serum and 10 lithium heparin samples per lot and per system.The limit of blank, LoB, was determined non-parametrically by rank order calculating the 95th percentile.99th percentile cutoff values were established non-parametrically using a well characterized population of apparently healthy subjects.Clinical correlation of cTnI levels above the 99% percentile to adjudicated AMI diagnosis was assessed in all-comer emergency department (ED) subjects in both lithium-heparin and serum samples.Results: The LoB results ranged from 0.11 to 0.90 ng/L with a typical value of 0.5 ng/L, and the LoD results ranged from 1.10 ng/L to 2.21 ng/L (95% Confidence Interval 1.05 to 2.54 ng/L).The assay measuring range is from the LoD to 25,000 ng/L.The limit of quantification, LoQ, defined as the cTnI concentration at 20% CV had a pooled value of 2.50 ng/L.The 99th percentile estimated with an apparently healthy population of n=2026 having an equal number of males and females had a gender-combined 99th percentile of 48 ng/L.The 99th percentile for females ranged from 37 to 41ng/L and for males 57 to 64 ng/L.There were no differences between matched Lithium Heparin plasma and Serum samples.The With-In Lab CV at the 99th percentile is less than 3%.Clinical sensitivity and clinical specificity in pooled-genders at 1, 2 and 3-hour post ED presentation ranged from 87.6%-93.2%and 90.0%-91.5% respectively. Conclusion:The ADVIA Centaur TNIH assay in development by Siemens has a 10% Total CV at a cTnI concentration 10-fold lower than the 99th percentile.This new assay allows the establishment of gender specific 99th percentile cutoffs and shows acceptable clinical utility in an all-comer ED population.[1] Under development.Future availability cannot be guaranteed.