{"id":21876,"date":"2022-08-10T04:34:00","date_gmt":"2022-08-09T20:34:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21876"},"modified":"2022-08-10T06:51:37","modified_gmt":"2022-08-09T22:51:37","slug":"icu-management-practice-abionic%e7%8b%ac%e7%89%b9%e7%9a%84%e8%84%93%e6%af%92%e7%97%87%e7%9b%91%e6%b5%8b%e6%96%b9%e6%a1%88","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21876","title":{"rendered":"[ICU Management & Practice]: Abionic\u72ec\u7279\u7684\u8113\u6bd2\u75c7\u76d1\u6d4b\u65b9\u6848"},"content":{"rendered":"\n

Abionic's Unique Sepsis Detection Solution<\/h2>\n\n\n\n

Based in Switzerland, Abionic<\/a> is an in vitro diagnostic company, uniquely positioned at the intersection of medical technology, biotechnology and nanotechnology. The company has developed an unparalleled nanofluidic technology-based platform, the abioSCOPE\u00ae to offer patients fast blood test results right at the Point-of-Care (PoC).<\/p>\n\n\n\n

The abioSCOPE\u00ae is a compact and ultra-fast diagnostic solution, providing quantitative results at the PoC from only a single drop of patient sample (blood, saliva, urine) and only within few minutes.<\/p>\n\n\n\n

The fast turnaround time of Abionic\u2019s tests relies on the ability of the nanofluidic to force molecules to go into a nanochannel, limiting their travel distance to a few hundred nanometers and thus significantly reducing incubation time. A washing step is not needed as the surface-to-volume ratio is extremely high, and non-specific background is negligible.<\/p>\n\n\n\n

Protein levels can thus be efficiently quantified within an ultra-short assay time, with high precision and accuracy on a closed, small, easy-to-operate platform, providing lab quality results at the PoC (Figure 1<\/strong>).<\/p>\n\n\n\n

By bringing together the ultra-rapid platform, abioSCOPE\u00ae and the Pancreatic Stone Protein (PSP) biomarker, Abionic\u2019s offer a unique sepsis solution enabling healthcare professionals to detect sepsis in just 5 minutes, up to 72h before the standard of care.<\/p>\n\n\n\n

Sepsis: The Need for Speed<\/strong><\/h3>\n\n\n\n

Sepsis requires prompt and tailored treatment; any delay in its diagnosis increases the risks of mortality and progression toward septic shock. Each hour of delay in the initiation of suitable antibiotic therapy was shown to decrease the survival of patients with septic shock by 7.6% (Kumar et al. 2006).<\/p>\n\n\n\n

Often a silent disease, sepsis seldom presents with clear signs and symptoms that would enable physicians to diagnose it early, until sudden clinical degradation occurs, with adverse and often fatal outcomes. Since the clinical complications of infection are reflected first by changes at the molecular and cellular levels, and later by the appearance of clinically overt signs, the timely measurement of sensitive and specific biomarkers can provide a unique window of opportunity for the timely initiation of adequate treatment.<\/p>\n\n\n\n

Therefore, the availability of an early and accurate sepsis biomarker at the patient\u2019s bedside is key to transforming sepsis care by enabling faster access to treatment, tailoring treatments, decreasing mortality and by lowering sepsis-related healthcare costs.<\/p>\n\n\n\n

Pancreatic Stone Protein (PSP)<\/strong><\/h3>\n\n\n\n

PSP is a biomarker produced mainly by the pancreas, small intestine, and stomach (Reding et al. 2017), and could be the missing tool for early detection of sepsis, i.e., infection and dysregulated organ response. Indeed, the hypothesis is that the pancreas is the first organ to react to sepsis and that increased PSP blood concentrations are associated with the development of sepsis (Pugin et al. 2021; Klein et al. 2015).<\/p>\n\n\n\n

With the abioSCOPE\u00ae\u00a0placed at the bedside of the patients, PSP levels can be measured rapidly (in as little as 5 minutes) at the PoC from a single drop of whole blood. This enables the close monitoring of blood PSP concentrations associated with the early development of sepsis, providing immediate, actionable results (Figure 2<\/strong>).<\/p>\n\n\n\n

Use of the PSP for the Diagnosis of Sepsis in <\/strong>ICUs<\/strong><\/h3>\n\n\n\n

Biomarkers have always played essential roles in the diagnosis of sepsis, but canonical markers such as C-reactive protein (CRP) and procalcitonin (PCT) have intrinsic limitations.<\/p>\n\n\n\n

PSP can differentiate, more accurately than CRP and PCT, infection from sepsis and an inflammatory state from sepsis in intensive care patients including severely burns (Klein et at al. 2020), in postoperative patients including cardiac surgery (Klein et al. 2015), in trauma patients (Keel et al. 2009) and on admission to the ICU (Llewelyn et al. 2013).<\/p>\n\n\n\n

A primary advantage of PSP\u00a0over canonical sepsis biomarkers is that its concentration\u00a0increases early, up to 72 hours in advance, in the course of sepsis\u00a0development (Pugin et al. 2021; Klein et al. 2015). This early increase is exemplified well in the\u00a0typical case of a 71-year-old hospitalised for a traumatic brain injury, which required immediate ICU admission with invasive mechanical ventilation, in\u00a0whom an increase in the PSP concentration early in sepsis\u00a0development was observed, opening a window of opportunity for\u00a0timely, targeted clinical management(Figure 3<\/strong>).<\/p>\n\n\n\n

It is important for intensive care physicians to be able to\u00a0differentiate between patients suffering from a systemic\u00a0inflammatory response without infection, compared to those\u00a0suffering from sepsis. This differential diagnosis is imperative\u00a0to administer the appropriate treatment.\u00a0A\u00a0multicentric study on critically ill patients published in\u00a0Critical Care, showed that PSP was the only biomarker able to\u00a0identify sepsis 72 hours before clinical diagnosis. Providing a large\u00a0window of opportunity to adapt the patient\u2019s clinical\u00a0management\u00a0(Figure 4<\/strong>) (Pugin et al. 2021).<\/p>\n\n\n\n

This multicentric study also showed that the combination of PSP and CRP had the best diagnostic accuracy (AUC 0.79 95%CI 0.72-0.86) the day of sepsis compared to procalcitonin (AUC 0.75 95%CI 0.68-0.82), either biomarker alone or other combinations of biomarkers.<\/p>\n\n\n\n

As PSP has shown excellent performance not only in the identification of sepsis, but also as a prognostic biomarker, serial PSP measurements every 24 hours should be implemented at the bedside with the abioSCOPE\u00ae and can aid the clinical management and early identification of sepsis in patients at risk or suspected of sepsis. This approach provides opportunities for the timely initiation of sepsis care bundles, appropriate preventive therapies and ICU monitoring of such patients.<\/p>\n\n\n\n

In addition, a constantly low PSP value is a strong indicator of a patient\u2019s stability to rule out sepsis (with high negative predictive value) in patients presenting a sepsis-like clinical picture; in such cases, no additional microbiological investigation or other sepsis-focused procedure is recommended. A low, stable PSP level also supports the decision to not administer or initiate unnecessary empiric antimicrobial treatment (Figure 5<\/strong>).<\/p>\n\n\n\n

The PSP test performed on the abioSCOPE\u00ae device is designed for on-demand use in the ICU. Compact, robust, and intuitive to use, it is fully compatible with hospital information systems and fits seamlessly into the workflow and can be positioned next to blood gas analysers. When sepsis is suspected, or needs to be ruled out, an immediate access to reliable test results is essential, without the need to wait for laboratory turnaround times. The information gained from serial PSP measurements may be crucial in determining whether a patient is developing nosocomial sepsis, preceding the appearance of overt clinical signs and symptoms, and guiding further diagnostic workup and therapeutic management, which may ultimately attenuate sepsis severity.<\/p>\n\n\n\n

Key Points<\/strong><\/h3>\n\n\n\n