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Joseph M. Neal - One of the best experts on this subject based on the ideXlab platform.

  • the third american society of regional anesthesia and pain Medicine Practice advisory on local anesthetic systemic toxicity executive summary 2017
    Regional Anesthesia and Pain Medicine, 2018
    Co-Authors: Joseph M. Neal, Michael J Barrington, Michael R Fettiplace, Marina Gitman, Stavros G Memtsoudis, Eva E Morwald, Daniel S Rubin, Guy Weinberg
    Abstract:

    The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity. WHAT'S NEW IN THIS UPDATE?: This interim update summarizes recent scientific findings that have enhanced our understanding of the mechanisms that lead to lipid emulsion reversal of LAST, including rapid partitioning, direct inotropy, and post-conditioning. Since the previous Practice advisory, epidemiological data have emerged that suggest a lower frequency of LAST as reported by single institutions and some registries, nevertheless a considerable number of events still occur within the general community. Contemporary case reports suggest a trend toward delayed presentation, which may mirror the increased use of ultrasound guidance (fewer intravascular injections), local infiltration techniques (slower systemic uptake), and continuous local anesthetic infusions. Small patient size and sarcopenia are additional factors that increase potential risk for LAST. An increasing number of reported events occur outside of the traditional hospital setting and involve non-anesthesiologists.

  • the second asra Practice advisory on neurologic complications associated with regional anesthesia and pain Medicine executive summary 2015
    Regional Anesthesia and Pain Medicine, 2015
    Co-Authors: Joseph M. Neal, Admir Hadzic, James P. Rathmell, James R. Hebl, Terese T. Horlocker, Marc A. Huntoon, Michael J Barrington, Richard Brull, Sandra L Kopp, James C Watson
    Abstract:

    Neurologic injury associated with regional anesthetic or pain Medicine procedures is extremely rare. The Second American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine focuses on those complications associated with mechanical, ischemic, or neurotoxic injury of the neuraxis or peripheral nervous system. As with the first advisory, this iteration does not focus on hemorrhagic or infectious complications or local anesthetic systemic toxicity, all of which are the subjects of separate Practice advisories. The current advisory offers recommendations to aid in the understanding and potential limitation of rare neurologic complications that may arise during the Practice of regional anesthesia and/or interventional pain Medicine. What’s New The Second American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine updates information that was originally presented at the Society’s first open forum on this subject (2005) and published in 2008. Portions of the second advisory were presented in an open forum (2012) and are herein updated, with attention to those topics subject to evolving knowledge since the first and second advisory conferences. The second advisory briefly summarizes recommendations that have not changed substantially. New to this iteration of the advisory is information related to the risk of nerve injury inherent to common orthopedic surgical procedures. Recommendations are expanded regarding the preventive role of various monitoring technologies such as ultrasound guidance and injection pressure monitoring. New clinical recommendations focus on emerging concerns including spinal stenosis and vertebral canal pathologies, blood pressure management during neuraxial anesthesia, administering blocks in anesthetized or deeply sedated patients, patients with preexisting neurologic disease, and inflammatory neuropathies. An updated diagnostic and treatment algorithm is presented.

  • asra Practice advisory on local anesthetic systemic toxicity
    Regional Anesthesia and Pain Medicine, 2010
    Co-Authors: Joseph M. Neal, Christopher M. Bernards, John F Butterworth, Guido Di Gregorio, Kenneth Drasner, Michael R Hejtmanek, Michael F Mulroy, Richard W Rosenquist, Guy L Weinberg
    Abstract:

    The American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity assimilates and summarizes current knowledge regarding the prevention, diagnosis, and treatment of this potentially fatal complication. It offers evidence-based and/or expert opinion-based recommendations for all physicians and advanced practitioners who routinely administer local anesthetics in potentially toxic doses. The advisory does not address issues related to local anesthetic-related neurotoxicity, allergy, or methemoglobinemia. Recommendations are based primarily on animal and human experimental trials, case series, and case reports. When objective evidence is lacking or incomplete, recommendations are supplemented by expert opinion from the Practice Advisory Panel plus input from other experts, medical specialty groups, and open forum. Specific recommendations are offered for the prevention, diagnosis, and treatment of local anesthetic systemic toxicity.

  • ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine.
    Regional anesthesia and pain medicine, 2008
    Co-Authors: Joseph M. Neal, Admir Hadzic, James P. Rathmell, Christopher M. Bernards, James R. Hebl, Quinn H. Hogan, Terese T. Horlocker, Lorri A. Lee, Eric J. Sorenson, Santhanam Suresh
    Abstract:

    Neurologic complications associated with regional anesthesia and pain Medicine Practice are extremely rare. The ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine addresses the etiology, differential diagnosis, prevention, and treatment of these complications. This Advisory does not focus on hemorrhagic and infectious complications, because they have been addressed by other recent ASRA Practice Advisories. The current Practice Advisory offers recommendations to aid in the understanding and potential limitation of neurologic complications that may arise during the Practice of regional anesthesia and pain Medicine.

Robert H Christenson - One of the best experts on this subject based on the ideXlab platform.

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines emerging biomarkers for primary prevention of cardiovascular disease
    Clinical Chemistry, 2009
    Co-Authors: Gary L Myers, Robert H Christenson, Mary Cushman, Christie M Ballantyne, Gerald R Cooper, Christine M Pfeiffer, Scott M Grundy, Darwin R Labarthe, Daniel Levy, Nader Rifai
    Abstract:

    Background: Heart disease and stroke continue to be the leading causes of death in the US. As a result, investigators continue to look for new and emerging biomarkers of disease risk. Because many of these emerging biomarkers are not as well documented as those of conventional lipid and lipoprotein risk factors, their value in clinical Practice needs to be critically appraised and appropriate guidelines developed for their proposed use. Content: The National Academy of Clinical Biochemistry (NACB) convened a multidisciplinary expert panel to develop laboratory Medicine Practice guidelines for a selected subset of these emerging risk factors as applied in a primary prevention setting of heart disease and stroke. The NACB expert panel selected lipoprotein subclasses and particle concentration, lipoprotein(a), apolipoproteins A-I and B, high sensitivity C-reactive protein (hsCRP), fibrinogen, white blood cell count, homocysteine, B-type natriuretic peptide (BNP), N-terminal proBNP (NT-proBNP), and markers of renal function as biomarkers that fell within the scope of these guidelines. Conclusions: Based on a thorough review of the published literature, only hsCRP met all of the stated criteria required for acceptance as a biomarker for risk assessment in primary prevention.

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines use of cardiac troponin and b type natriuretic peptide or n terminal prob type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure
    Clinical Chemistry, 2007
    Co-Authors: Allan S Jaffe, David A Morrow, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Robert H Christenson, Fred S Apple, Gary L Francis, W Wilson H Tang, Christopher P Cannon
    Abstract:

    Over the past decade, cardiac troponin (cTn)1 has become the cornerstone laboratory Medicine measurement for assessment of myocardial infarction (MI) in suspected acute coronary syndrome (ACS) patients. In the past 5–7 years, methods for measuring the natriuretic peptide B-type natriuretic peptide (BNP) and its inert cometabolite N-terminal proBNP (NT-proBNP) have become available, and much knowledge has accumulated regarding their clinical use in the context of heart failure and hemodynamic stress. In addition to ACS and heart failure, there are common and clinically important patient cohorts in whom these measurements can aid in diagnosis and management. For this reason, the National Academy of Clinical Biochemistry (NACB) formed a Laboratory Medicine Practice Guidelines (LMPG) committee to extend cardiac biochemical marker recommendations and establish modern guidelines for utilization …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Circulation, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson
    Abstract:

    I. OVERVIEW OF THE ACUTE CORONARYSYNDROME e357A. Definition of Terms e357B. Pathogenesis and Management of ACS e357II. USE OF BIOCHEMICAL MARKERS IN THEINITIAL EVALUATION OF ACS e358A. Diagnosis of Myocardial Infarction e3581. Biochemical Markers of MyocardialNecrosis e3582. Optimal Timing of Sample Acquisition.......e3593. Criteria for Diagnosis of MI e3604. Additional Considerations in the Use ofBiomarkers for Diagnosis of MI e360B. Early Risk Stratification e3611. Biochemical Markers of Cardiac Injury.......e361a. Pathophysiology e361b. Relationship to Clinical Outcomes.........e361c. Decision-Limits e362d. Therapeutic Decision-Making e3622. Natriuretic Peptides e362a. Pathophysiology e362b. Relationship to Clinical Outcomes.........e363c. Decision-Limits e364d. Therapeutic Decision-Making e3653. Biochemical Markers of Inflammation........e365a. Pathophysiology e365b. Relationship to Clinical Outcomes.........e365c. Decision-Limits e365d. Therapeutic Decision-Making e3674. Biochemical Markers of Ischemia e3675. Multimarker Approach e3676. Other Novel Markers e368III. USE OF BIOCHEMICAL MARKERS IN THEMANAGEMENT OF NSTEACS e368A. Clinical Decision-Making e3681. Biochemical Markers of Cardiac Injury.......e3682. Other Biochemical Markers e369

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Clinical Chemistry, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson, Gary S Francis, Fred S Apple, Wilson Tang
    Abstract:

    ### a. definition of terms Acute coronary syndrome (ACS)1 refers to a constellation of clinical symptoms caused by acute myocardial ischemia (1)(2). Owing to their higher risk for cardiac death or ischemic complications, patients with ACS must be identified among the estimated 8 million patients with nontraumatic chest symptoms presenting for emergency evaluation each year in the US (3). In Practice, the terms suspected or possible ACS are often used by medical personnel early in the process of evaluation to describe patients for whom the symptom complex is consistent with ACS but the diagnosis has not yet been conclusively established (1). Patients with ACS are subdivided into 2 major categories based on the 12-lead electrocardiogram (ECG) at presentation (Fig. 1⇓ ): those with new ST-segment …

David A Morrow - One of the best experts on this subject based on the ideXlab platform.

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines use of cardiac troponin and b type natriuretic peptide or n terminal prob type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure
    Clinical Chemistry, 2007
    Co-Authors: Allan S Jaffe, David A Morrow, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Robert H Christenson, Fred S Apple, Gary L Francis, W Wilson H Tang, Christopher P Cannon
    Abstract:

    Over the past decade, cardiac troponin (cTn)1 has become the cornerstone laboratory Medicine measurement for assessment of myocardial infarction (MI) in suspected acute coronary syndrome (ACS) patients. In the past 5–7 years, methods for measuring the natriuretic peptide B-type natriuretic peptide (BNP) and its inert cometabolite N-terminal proBNP (NT-proBNP) have become available, and much knowledge has accumulated regarding their clinical use in the context of heart failure and hemodynamic stress. In addition to ACS and heart failure, there are common and clinically important patient cohorts in whom these measurements can aid in diagnosis and management. For this reason, the National Academy of Clinical Biochemistry (NACB) formed a Laboratory Medicine Practice Guidelines (LMPG) committee to extend cardiac biochemical marker recommendations and establish modern guidelines for utilization …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical utilization of cardiac biomarker testing in heart failure
    Circulation, 2007
    Co-Authors: W Wilso H Tang, David A Morrow, Kristin L Newby, Gary S Francis, Christophe P Canno, Robe L Jesse, Ala Storrow, Robe H Christenso, Fred S Apple, Jan Ravkilde
    Abstract:

    ### A. Context of Biochemical Marker Testing in Heart Failure Biochemical marker testing has revolutionized the approach to diagnosis and management of heart failure over the past decade. There is an unsurpassed excitement in the heart failure community that significant advances in our understanding of currently available and future cardiac biomarkers will facilitate improved characterization of heart failure disease states and promote individualized therapy in heart failure and beyond. However, like most novel diagnostic tests, the promising findings from pivotal trials have met with ongoing challenges when applied in the clinical setting. The material discussed in this guidelines document addresses clinical use of BNP/NT-proBNP and cardiac troponin testing in the context of heart failure diagnosis, risk stratification and management, including therapeutic guidance in adult (>18 year-old) patients. Together with the associated document titled “ National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biomarkers of Heart Failure ”, …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Circulation, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson
    Abstract:

    I. OVERVIEW OF THE ACUTE CORONARYSYNDROME e357A. Definition of Terms e357B. Pathogenesis and Management of ACS e357II. USE OF BIOCHEMICAL MARKERS IN THEINITIAL EVALUATION OF ACS e358A. Diagnosis of Myocardial Infarction e3581. Biochemical Markers of MyocardialNecrosis e3582. Optimal Timing of Sample Acquisition.......e3593. Criteria for Diagnosis of MI e3604. Additional Considerations in the Use ofBiomarkers for Diagnosis of MI e360B. Early Risk Stratification e3611. Biochemical Markers of Cardiac Injury.......e361a. Pathophysiology e361b. Relationship to Clinical Outcomes.........e361c. Decision-Limits e362d. Therapeutic Decision-Making e3622. Natriuretic Peptides e362a. Pathophysiology e362b. Relationship to Clinical Outcomes.........e363c. Decision-Limits e364d. Therapeutic Decision-Making e3653. Biochemical Markers of Inflammation........e365a. Pathophysiology e365b. Relationship to Clinical Outcomes.........e365c. Decision-Limits e365d. Therapeutic Decision-Making e3674. Biochemical Markers of Ischemia e3675. Multimarker Approach e3676. Other Novel Markers e368III. USE OF BIOCHEMICAL MARKERS IN THEMANAGEMENT OF NSTEACS e368A. Clinical Decision-Making e3681. Biochemical Markers of Cardiac Injury.......e3682. Other Biochemical Markers e369

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Clinical Chemistry, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson, Gary S Francis, Fred S Apple, Wilson Tang
    Abstract:

    ### a. definition of terms Acute coronary syndrome (ACS)1 refers to a constellation of clinical symptoms caused by acute myocardial ischemia (1)(2). Owing to their higher risk for cardiac death or ischemic complications, patients with ACS must be identified among the estimated 8 million patients with nontraumatic chest symptoms presenting for emergency evaluation each year in the US (3). In Practice, the terms suspected or possible ACS are often used by medical personnel early in the process of evaluation to describe patients for whom the symptom complex is consistent with ACS but the diagnosis has not yet been conclusively established (1). Patients with ACS are subdivided into 2 major categories based on the 12-lead electrocardiogram (ECG) at presentation (Fig. 1⇓ ): those with new ST-segment …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical utilization of cardiac biomarker testing in heart failure writing group members
    2007
    Co-Authors: Gary S Francis, David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Alan B Storrow, R Christenson, Fred Apple, Jan Ravkilde
    Abstract:

    I. Overview of Heart Failure e99A. Context of Biochemical Marker Testing inHeart Failure e99B. Background and Definition of Terms e100C. B-type Natriuretic Peptide (BNP) and Amino-Terminal proB-Type Natriuretic Peptide(NT-proBNP) Metabolism and Measurement . . . .e100II. Use of Biochemical Markers in the InitialEvaluation of Heart Failure e101A. Diagnosis of Heart Failure e1011. BNP and NT-proBNP for Diagnosis of AcuteDecompensated Heart Failure e1022. BNP or NT-proBNP for Confirmation of theHeart Failure Diagnosis e103B. Risk Stratification of Heart Failure e1031. Risk stratification of Patients With andWithout Heart Failure Using BNP orNT-proBNP e1032. Risk Stratification of Patients With HeartFailure Using Cardiac Troponin e104III. Use of Biochemical Markers in Screening forCardiac Dysfunction e104A. BNP or NT-proBNP for Screening HeartFailure and Dysfunction e104B. Approaches for Screening for CardiacDysfunction e104IV. Use of Biochemical Markers in GuidingManagement of Heart Failure e105A. Monitoring Therapy Using BNP orNT-proBNP Guidance e105V. References e105

Jan Ravkilde - One of the best experts on this subject based on the ideXlab platform.

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines use of cardiac troponin and b type natriuretic peptide or n terminal prob type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure
    Clinical Chemistry, 2007
    Co-Authors: Allan S Jaffe, David A Morrow, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Robert H Christenson, Fred S Apple, Gary L Francis, W Wilson H Tang, Christopher P Cannon
    Abstract:

    Over the past decade, cardiac troponin (cTn)1 has become the cornerstone laboratory Medicine measurement for assessment of myocardial infarction (MI) in suspected acute coronary syndrome (ACS) patients. In the past 5–7 years, methods for measuring the natriuretic peptide B-type natriuretic peptide (BNP) and its inert cometabolite N-terminal proBNP (NT-proBNP) have become available, and much knowledge has accumulated regarding their clinical use in the context of heart failure and hemodynamic stress. In addition to ACS and heart failure, there are common and clinically important patient cohorts in whom these measurements can aid in diagnosis and management. For this reason, the National Academy of Clinical Biochemistry (NACB) formed a Laboratory Medicine Practice Guidelines (LMPG) committee to extend cardiac biochemical marker recommendations and establish modern guidelines for utilization …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical utilization of cardiac biomarker testing in heart failure
    Circulation, 2007
    Co-Authors: W Wilso H Tang, David A Morrow, Kristin L Newby, Gary S Francis, Christophe P Canno, Robe L Jesse, Ala Storrow, Robe H Christenso, Fred S Apple, Jan Ravkilde
    Abstract:

    ### A. Context of Biochemical Marker Testing in Heart Failure Biochemical marker testing has revolutionized the approach to diagnosis and management of heart failure over the past decade. There is an unsurpassed excitement in the heart failure community that significant advances in our understanding of currently available and future cardiac biomarkers will facilitate improved characterization of heart failure disease states and promote individualized therapy in heart failure and beyond. However, like most novel diagnostic tests, the promising findings from pivotal trials have met with ongoing challenges when applied in the clinical setting. The material discussed in this guidelines document addresses clinical use of BNP/NT-proBNP and cardiac troponin testing in the context of heart failure diagnosis, risk stratification and management, including therapeutic guidance in adult (>18 year-old) patients. Together with the associated document titled “ National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biomarkers of Heart Failure ”, …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Circulation, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson
    Abstract:

    I. OVERVIEW OF THE ACUTE CORONARYSYNDROME e357A. Definition of Terms e357B. Pathogenesis and Management of ACS e357II. USE OF BIOCHEMICAL MARKERS IN THEINITIAL EVALUATION OF ACS e358A. Diagnosis of Myocardial Infarction e3581. Biochemical Markers of MyocardialNecrosis e3582. Optimal Timing of Sample Acquisition.......e3593. Criteria for Diagnosis of MI e3604. Additional Considerations in the Use ofBiomarkers for Diagnosis of MI e360B. Early Risk Stratification e3611. Biochemical Markers of Cardiac Injury.......e361a. Pathophysiology e361b. Relationship to Clinical Outcomes.........e361c. Decision-Limits e362d. Therapeutic Decision-Making e3622. Natriuretic Peptides e362a. Pathophysiology e362b. Relationship to Clinical Outcomes.........e363c. Decision-Limits e364d. Therapeutic Decision-Making e3653. Biochemical Markers of Inflammation........e365a. Pathophysiology e365b. Relationship to Clinical Outcomes.........e365c. Decision-Limits e365d. Therapeutic Decision-Making e3674. Biochemical Markers of Ischemia e3675. Multimarker Approach e3676. Other Novel Markers e368III. USE OF BIOCHEMICAL MARKERS IN THEMANAGEMENT OF NSTEACS e368A. Clinical Decision-Making e3681. Biochemical Markers of Cardiac Injury.......e3682. Other Biochemical Markers e369

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Clinical Chemistry, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson, Gary S Francis, Fred S Apple, Wilson Tang
    Abstract:

    ### a. definition of terms Acute coronary syndrome (ACS)1 refers to a constellation of clinical symptoms caused by acute myocardial ischemia (1)(2). Owing to their higher risk for cardiac death or ischemic complications, patients with ACS must be identified among the estimated 8 million patients with nontraumatic chest symptoms presenting for emergency evaluation each year in the US (3). In Practice, the terms suspected or possible ACS are often used by medical personnel early in the process of evaluation to describe patients for whom the symptom complex is consistent with ACS but the diagnosis has not yet been conclusively established (1). Patients with ACS are subdivided into 2 major categories based on the 12-lead electrocardiogram (ECG) at presentation (Fig. 1⇓ ): those with new ST-segment …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical utilization of cardiac biomarker testing in heart failure writing group members
    2007
    Co-Authors: Gary S Francis, David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Alan B Storrow, R Christenson, Fred Apple, Jan Ravkilde
    Abstract:

    I. Overview of Heart Failure e99A. Context of Biochemical Marker Testing inHeart Failure e99B. Background and Definition of Terms e100C. B-type Natriuretic Peptide (BNP) and Amino-Terminal proB-Type Natriuretic Peptide(NT-proBNP) Metabolism and Measurement . . . .e100II. Use of Biochemical Markers in the InitialEvaluation of Heart Failure e101A. Diagnosis of Heart Failure e1011. BNP and NT-proBNP for Diagnosis of AcuteDecompensated Heart Failure e1022. BNP or NT-proBNP for Confirmation of theHeart Failure Diagnosis e103B. Risk Stratification of Heart Failure e1031. Risk stratification of Patients With andWithout Heart Failure Using BNP orNT-proBNP e1032. Risk Stratification of Patients With HeartFailure Using Cardiac Troponin e104III. Use of Biochemical Markers in Screening forCardiac Dysfunction e104A. BNP or NT-proBNP for Screening HeartFailure and Dysfunction e104B. Approaches for Screening for CardiacDysfunction e104IV. Use of Biochemical Markers in GuidingManagement of Heart Failure e105A. Monitoring Therapy Using BNP orNT-proBNP Guidance e105V. References e105

Christopher P Cannon - One of the best experts on this subject based on the ideXlab platform.

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines use of cardiac troponin and b type natriuretic peptide or n terminal prob type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure
    Clinical Chemistry, 2007
    Co-Authors: Allan S Jaffe, David A Morrow, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Robert H Christenson, Fred S Apple, Gary L Francis, W Wilson H Tang, Christopher P Cannon
    Abstract:

    Over the past decade, cardiac troponin (cTn)1 has become the cornerstone laboratory Medicine measurement for assessment of myocardial infarction (MI) in suspected acute coronary syndrome (ACS) patients. In the past 5–7 years, methods for measuring the natriuretic peptide B-type natriuretic peptide (BNP) and its inert cometabolite N-terminal proBNP (NT-proBNP) have become available, and much knowledge has accumulated regarding their clinical use in the context of heart failure and hemodynamic stress. In addition to ACS and heart failure, there are common and clinically important patient cohorts in whom these measurements can aid in diagnosis and management. For this reason, the National Academy of Clinical Biochemistry (NACB) formed a Laboratory Medicine Practice Guidelines (LMPG) committee to extend cardiac biochemical marker recommendations and establish modern guidelines for utilization …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Circulation, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson
    Abstract:

    I. OVERVIEW OF THE ACUTE CORONARYSYNDROME e357A. Definition of Terms e357B. Pathogenesis and Management of ACS e357II. USE OF BIOCHEMICAL MARKERS IN THEINITIAL EVALUATION OF ACS e358A. Diagnosis of Myocardial Infarction e3581. Biochemical Markers of MyocardialNecrosis e3582. Optimal Timing of Sample Acquisition.......e3593. Criteria for Diagnosis of MI e3604. Additional Considerations in the Use ofBiomarkers for Diagnosis of MI e360B. Early Risk Stratification e3611. Biochemical Markers of Cardiac Injury.......e361a. Pathophysiology e361b. Relationship to Clinical Outcomes.........e361c. Decision-Limits e362d. Therapeutic Decision-Making e3622. Natriuretic Peptides e362a. Pathophysiology e362b. Relationship to Clinical Outcomes.........e363c. Decision-Limits e364d. Therapeutic Decision-Making e3653. Biochemical Markers of Inflammation........e365a. Pathophysiology e365b. Relationship to Clinical Outcomes.........e365c. Decision-Limits e365d. Therapeutic Decision-Making e3674. Biochemical Markers of Ischemia e3675. Multimarker Approach e3676. Other Novel Markers e368III. USE OF BIOCHEMICAL MARKERS IN THEMANAGEMENT OF NSTEACS e368A. Clinical Decision-Making e3681. Biochemical Markers of Cardiac Injury.......e3682. Other Biochemical Markers e369

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical characteristics and utilization of biochemical markers in acute coronary syndromes
    Clinical Chemistry, 2007
    Co-Authors: David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Jan Ravkilde, Alan B Storrow, Robert H Christenson, Gary S Francis, Fred S Apple, Wilson Tang
    Abstract:

    ### a. definition of terms Acute coronary syndrome (ACS)1 refers to a constellation of clinical symptoms caused by acute myocardial ischemia (1)(2). Owing to their higher risk for cardiac death or ischemic complications, patients with ACS must be identified among the estimated 8 million patients with nontraumatic chest symptoms presenting for emergency evaluation each year in the US (3). In Practice, the terms suspected or possible ACS are often used by medical personnel early in the process of evaluation to describe patients for whom the symptom complex is consistent with ACS but the diagnosis has not yet been conclusively established (1). Patients with ACS are subdivided into 2 major categories based on the 12-lead electrocardiogram (ECG) at presentation (Fig. 1⇓ ): those with new ST-segment …

  • national academy of clinical biochemistry laboratory Medicine Practice guidelines clinical utilization of cardiac biomarker testing in heart failure writing group members
    2007
    Co-Authors: Gary S Francis, David A Morrow, Christopher P Cannon, Robert L Jesse, Kristin L Newby, Alan B Storrow, R Christenson, Fred Apple, Jan Ravkilde
    Abstract:

    I. Overview of Heart Failure e99A. Context of Biochemical Marker Testing inHeart Failure e99B. Background and Definition of Terms e100C. B-type Natriuretic Peptide (BNP) and Amino-Terminal proB-Type Natriuretic Peptide(NT-proBNP) Metabolism and Measurement . . . .e100II. Use of Biochemical Markers in the InitialEvaluation of Heart Failure e101A. Diagnosis of Heart Failure e1011. BNP and NT-proBNP for Diagnosis of AcuteDecompensated Heart Failure e1022. BNP or NT-proBNP for Confirmation of theHeart Failure Diagnosis e103B. Risk Stratification of Heart Failure e1031. Risk stratification of Patients With andWithout Heart Failure Using BNP orNT-proBNP e1032. Risk Stratification of Patients With HeartFailure Using Cardiac Troponin e104III. Use of Biochemical Markers in Screening forCardiac Dysfunction e104A. BNP or NT-proBNP for Screening HeartFailure and Dysfunction e104B. Approaches for Screening for CardiacDysfunction e104IV. Use of Biochemical Markers in GuidingManagement of Heart Failure e105A. Monitoring Therapy Using BNP orNT-proBNP Guidance e105V. References e105