Mobile Stroke Unit (MSU) |
Imaging and a variety of Blood-tests. Integration of CT scanners and POCTs in ambulances, IV-tPA treatment can be started on-site |
Consists of a registered nurse, paramedic, emergency medical technician, and a CT technologist, in addition, POCT are used, which includes coagulation profile, complete blood count, and blood chemistry |
Pre-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[79,86,87,88,89,90,91] |
CoaguChek® (Roche) |
Test strips with electro-chemical detection. Based on amperometric (electrochemical) determination of the PT time after activation of the coagulation with human recombinant thromboplastin, results are obtained within 1 min |
Convenient, portable and user-friendly device for monitoring oral anticoagulation therapy which can determine the INR value from a drop of capillary whole blood |
Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[91,92,93,94,95] |
Hemochron® Junior (ITC) |
Optical detection. Micro-coagulation system, results within minutes |
POCTs monitoring of: (1) ACT-LR, (2) ACT, (3) PT, (4) Citrate PT, (5) APTT and (6) Citrate APTT |
Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[96] |
PocH-100i hematology analyzer (Sysmex) |
Micro-fluidics. WBCs, RBCs and PLTs are counted using the direct current detection method with hydrodynamic focusing technology. Hemoglobin analysis is conducted using a non-cyanide method |
Provides a full blood count and a 3-part differential leukocyte count |
Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[91,96,97] |
i-STAT (Abbott) |
Micro-fluidics. Based on advanced microfluidic and deliver fast, reliable lab accurate results within 2 min |
Bedside care tests such as blood gases, electrolytes, metabolites and coagulation |
Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[91,98,99,100] |
Reflotron® plus analyzer (Roche, Cobas series) |
Test strips with optical detection (Reflectance photometry). Single-test clinical chemistry system which is able to measure whole blood, plasma or serum for: liver and pancreas enzymes, metabolites and blood lipids. Results within 2–3 mins |
Used for blood clinical-chemistry parameters measurement, such as c-glutamyltransferase, p-amylase, and glucose |
Pre/In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[96] |
Abbott AxSYM® BNP/Alere Triage® BNP/i-STAT BNP |
Optical Detection (AxSYM)/Fluorescent detection (Triage)/Electro-chemical sensor on a silicon chip (i-STAT). BNP POCT. |
BNP elevated serum levels in stroke patients show (1) correlation with CEI stroke, (2) increased mortality and (3) indication on second stroke recurrence |
In/Post-hospital: Improves stroke prognostic (correlation to CEI) and stroke recovery (indication on second stroke reoccurrence) |
[88,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126] |
Cornell University, State University of New York and the New York Presbyterian Hospital |
Luminescent detection. NSE POCT based on enzymes tethered to nanoparticles |
NSE elevated serum levels in stroke patients assist in distinguishing stroke from mimics, an important first step in expediting the diagnostic process |
In-hospital: Improves stroke diagnosis and reduces time-to-IV-tPA admission |
[127,128,129,130,131,132,133] |
Prediction Sciences LLC |
Lateral flow POCT for the proteomic marker cellular fibronectin (c-Fn) |
Fibronectin (c-Fn) elevated serum levels in stroke patients at IV-tPA admission can identify if the patient is at high or low risk for a subsequent hemorrhage |
In-hospital: Reduces time-to-IV-tPA admission |
[124] |
ReST™ (Valtari Bio™ Inc.) |
Rapid evaluation stroke triage POCT for the measurement of blood brain-specific biomarkers associated with immune responses, results within 10 min |
Following stroke, the immune system is activated. The degree and direction of the immune system activation allow the accurate identification of acute stroke from non-stroke |
In-hospital: Initial stroke versus no stroke diagnosis |
[134,135,136] |
SMARTChip (Sarissa Biomedical) |
Micro-electrode POCT device for stroke diagnosis that measures purines from a drop of whole blood and give the reading within minutes |
Can be used by paramedics, which will allow faster identification of stoke victims at the point of injury |
In-hospital: Stroke diagnosis |
[137] |
PFA-100®, Platelet Function Analyzer (Dade Behring) |
High-shear force dynamic flow system POCT that assesses platelet aggregation under high shear, mimicking platelet-rich thrombus formation after injury to a small vessel wall under flow conditions |
Rapid and reliable identification of aspirin non-responsive patients, without the requirement of a specialized laboratory |
Post-hospital: Prevention of second stroke recurrence |
[138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155] |
Ultegra-RPFA VerifyNow Aspirin® test (Accumetrics) |
Optical detection. POCT based on turbidimetric optical detection of platelet aggregation in whole blood. As aggregation occurs, the system converts luminosity transmittance results into ‘Aspirin Reaction Units’ |
Rapid and reliable identification of aspirin non-responsive patients, without the requirement of a specialized laboratory |
Post-hospital: Prevention of second stroke recurrence |
[138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154] |