Biochemical analysis is becoming increasingly sophisticated. The number of metabolites that can be rapidly quantified in blood has grown tremendously in the last 20 years. Many of these tests can now be performed at the bedside, on line with indwelling catheters, or ultimately in vivo.
The clinical need for these analyses is clear. Many clinical situations arise in the critical care setting that warrant immediate blood gas analysis, blood glucose levels, or serum potassium levels. Even with an expeditious stat laboratory in the intensive care unit, repeat tests are frequently required before the first result is returned because the clinical situation has changed. Ever-increasing concern for blood-borne infectious diseases has led to the identification of methods of evaluating electrolyte and metabolite levels which minimize the risk of contamination of the health care provider. A variety of chemical sensing techniques have been developed ranging from transcutaneous analyses to on-line ex vivo techniques, and ultimately on-line in vivo biochemical analysis technology. However, it must be remembered that, although these technological advances are astounding and have many theoretical benefits, the practical clinical benefits may not be as great. The technological advances necessary to make in vivo sensors biocompatible will probably be extremely expensive; consequently a cost-benefit analysis in the increasingly cost-conscious medical environment may ultimately determine the success or failure of in vivo biochemical analysis.
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