Niche point-of-care endocrine testing–Reviews of intraoperative parathyroid hormone and cortisol monitoring

Li Sheng Chen, Ravinder Jit Singh

Research output: Contribution to journalReview article

Abstract

Point-of-care (POC) testing, which provides quick test results in near-patient settings with easy-to-use devices, has grown continually in recent decades. Among near-patient and on-site tests, rapid intraoperative and intra-procedural assays are used to quickly deliver critical information and thereby improve patient outcomes. Rapid intraoperative parathyroid hormone (ioPTH) monitoring measures postoperative reduction of parathyroid hormone (PTH) to predict surgical outcome in patients with primary hyperparathyroidism, and therefore contributes to the change of parathyroidectomy to a minimally invasive procedure. In this review, recent progress in applying ioPTH monitoring to patients with secondary and tertiary hyperparathyroidism and other testing areas is discussed. In-suite cortisol monitoring facilitates the use of adrenal vein sampling (AVS) for the differential diagnosis of primary aldosteronism and adrenocorticotropic hormone (ACTH)-independent Cushing syndrome. In clinical and psychological research settings, POC testing is also useful for rapidly assessing cortisol in plasma and saliva samples as a biomarker of stress. Careful resource utilization and coordination among stakeholders help to determine the best approach for implementing cost-effective POC testing. Technical advances in integrating appropriate biosensors with microfluidics-based devices hold promise for future real-time POC cortisol monitoring.

Original languageEnglish (US)
Pages (from-to)115-128
Number of pages14
JournalCritical Reviews in Clinical Laboratory Sciences
Volume55
Issue number2
DOIs
StatePublished - Feb 17 2018

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Keywords

  • adrenal vein sampling
  • cortisol biosensors
  • intra-procedural cortisol monitoring
  • intraoperative PTH
  • parathyroidectomy
  • Point-of-care testing

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Clinical Biochemistry
  • Biochemistry, medical

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