Extracellular Vesicles for Acute Care Testing: A Review of Potential Laboratory Applications

BACKGROUND: Rapid, accurate diagnosis in acute and emergent care remains a major challenge, with delays directly impacting patient outcomes. Extracellular vesicles (EVs), nanoscale membranous particles secreted by all cell types and found in virtually all biological fluids, have the potential to transform acute diagnostics as minimally invasive biomarkers. As key intercellular messengers and carriers of biological cargo, EVs reflect the physiological and pathological states of their parent cells. While EV research has largely focused on chronic diseases such as cancer and neurodegeneration, their role in acute pathologies remains under-investigated. CONTENT: This review describes the current landscape of EVs in laboratory medicine, with a focus on their potential for acute and emergent conditions, including sepsis, stroke, traumatic brain injury, and myocardial infarction. We examine advances in EV isolation and characterization techniques and discuss the unique challenges of implementing these approaches in a clinical setting. In particular, we highlight emerging technologies that aim to address existing barriers, including lack of standardization, long processing times, and limited clinical scalability. SUMMARY: By summarizing existing knowledge and identifying critical research gaps, this review intends to refocus attention toward EV applications for acute care. As EV-based diagnostics continue to advance, their successful integration into clinical work flows has the potential to significantly transform healthcare delivery, enabling real-time, personalized diagnostics and improving health outcomes across a wide range of settings.