Point-of-Care Troponin Test
Overview
Point-of-Care (POC) Troponin Testing provides rapid assessment of cardiac biomarkers at the bedside, enabling quick decision-making in pediatric cardiac emergencies.
Key Points
- Results available within 10-20 minutes
- Requires minimal blood volume (15-20 μL)
- High sensitivity and specificity for cardiac injury
- Used in emergency and critical care settings
- Different from standard laboratory troponin testing
Testing Methodology
Biochemical Basis
- Cardiac Troponin Types
- Troponin T (cTnT)
- Troponin I (cTnI)
- Troponin C (less specific)
- Detection Methods
- Immunochromatographic assays
- Fluorescence detection
- Electrochemical sensors
Available Technologies
- Qualitative tests (positive/negative)
- Quantitative measurements
- High-sensitivity assays
- Multi-marker platforms
Clinical Applications
Primary Indications
- Acute Chest Pain Assessment
- Post-cardiac Surgery Monitoring
- Myocarditis Evaluation
- Cardiac Contusion Assessment
- Chemotherapy Cardiotoxicity Monitoring
Specific Pediatric Conditions
- Kawasaki Disease
- Early detection of cardiac involvement
- Monitoring treatment response
- Congenital Heart Disease
- Post-operative monitoring
- Complications assessment
- Cardiac Trauma
- Initial evaluation
- Serial monitoring
Testing Procedure
Pre-analytical Phase
- Equipment Preparation
- Test device warming
- Quality control checks
- Reagent storage verification
- Patient Preparation
- Identity verification
- Clinical history documentation
- Timing considerations
Sample Collection
- Blood Collection Methods
- Finger stick
- Heel stick (neonates)
- Whole blood from line
- Volume Requirements
- Minimum volume specifications
- Sample handling
- Time considerations
Result Interpretation
Reference Ranges
- Age-specific cutoffs
- Neonates: Higher baseline
- Infants: Transitional values
- Children: Adult-like ranges
- Device-specific considerations
- Analytical sensitivity
- Precision ranges
- Interference factors
Clinical Correlation
- Timing of elevation
- Rate of change
- Integration with other findings
- Serial testing strategy
Result Limitations
- False positives
- Hemolysis
- Cross-reactivity
- Analytical interference
- False negatives
- Early testing
- Hook effect
- Technical errors
Pediatric-Specific Considerations
Age-Related Factors
- Developmental Variations
- Cardiac maturation
- Biomarker expression
- Reference intervals
- Technical Challenges
- Sample volume limitations
- Collection difficulties
- Movement artifacts
Special Populations
- Neonates
- Birth-related elevations
- Transitional circulation
- Athletes
- Exercise-induced changes
- Training effects
- Chronic Conditions
- Renal dysfunction
- Muscular disorders
