The use of microfluidic devices is highly attractive in the field of biomedical and clinical assessments, as their portability and fast response time have become crucial in providing opportune therapeutic treatments to patients. The applications of microfluidics in clinical diagnosis and point‐of‐care devices are continuously growing. The present review article discusses three main fields where miniaturized devices are successfully employed in clinical applications. The quantification of ions, sugars, and small metabolites is examined considering the analysis of bodily fluids samples and the quantification of this type of analytes employing real‐time wearable devices. The discussion covers the level of maturity that the devices have reached as well as cost‐effectiveness. The analysis of proteins with clinical relevance is presented and organized by the function of the proteins. The last section covers devices that can perform single‐cell metabolomic and proteomic assessments. Each section discusses several strategically selected recent reports on microfluidic devices successfully employed for clinical assessments, to provide the reader with a wide overview of the plethora of novel systems and microdevices developed in the last 5 years. In each section, the novel aspects and main contributions of each reviewed report are highlighted. Finally, the conclusions and future outlook section present a summary and speculate on the future direction of the field of miniaturized devices for clinical applications.
CASE DESCRIPTIONA 29-year-old man presented to the Emergency Department with head trauma following a motorcycle accident. On arrival, he was hypoxic and unresponsive. Examinations showed skull fractures and hemorrhage, with climbing intracranial pressures. Laboratory tests revealed dangerously low potassium concentrations (Ͻ2 mmol/L; reference interval, 3.6 -5.2 mmol/L) over an extended period of time (Fig. 1). When the physician was called, the laboratory was informed that the low potassium concentrations were expected for this patient. QUESTIONS 1. What are the common causes of hypokalemia? 2. Why was the hypokalemia expected in this case? 3. Why should potassium replenishment be held on this patient?The answers are below.
ANSWERSHypokalemia can result from decreased intake (rare), translocation into cells (insulin, beta adrenergic agonists), or gastrointestinal/urine losses (diarrhea/aldosterone) (1 ). The patient discussed in this case was put on hypothermia treatment to minimize brain injury. The hypokalemia was secondary to an intracellular shifting of potassium into cells under the hypothermia treatment (2, 3 ). Administration of potassium in this setting can be dangerous; reversal of hypothermia can subsequently cause severe hyperkalemia and life-threatening cardiac complications (2 ).
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