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Near-Patient Testing: The Advantages of C-Reactive Protein in Hematological Testing

arrow aplasia is defined by two parameters: the extent and the duration of cytopenias, particularly neutropenia. There is a clear relation between these two parameters and the incidence of infection, which is high after one week of polynuclear levels below 500 cells/mm3. The same applies to thrombopenia and the risk of bleeding, which increases with platelet counts below 30,000 platelets/mm3, and becomes more serious as counts drop further. A distinction is made between short-term aplasia (<1 week) and long term aplasia (>1 week). Anti-infection strategies take into account the expected duration of the aplasia, its conditions of onset (e.g. during leukemia induction therapy, which may be associated with a pre-existing infection), and fever monitoring, associated with pathogen identification in only 25-30% of these cases, leading to emergency requirements in some instances. Based on solid clinical analysis and a few simple laboratory tools, such as CBC and CRP measurement, concise decisions on patient management can be made.

CRP testing is used in monitoring infection profiles by noting increasing levels, which correlate with temperature fluctuations during fever. This allows a dynamic analysis of the infection progression and can lead to more accurate and prompt administration of antibiotic treatment, or withdrawal of antibiotic therapy if required. Conversely an observed drop in CRP levels and a rise in white blood cells (WBC) can allow an earlier patient discharge. The combination of CRP and CBC analyses can therefore improve the follow-up of aplasia patients who may have other hematological diseases. Thus, relocating these tests closer to the patients bedside is obvious as it provides reliability, simplicity and a rapid turnaround of results. Used as part of a cost-control plan, near-patient CRP and CBC testing can reduce the costs associated with inappropriate antibiotic treatment and prolonged hospital stays. Moreov
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