Advances in Chromatography-Free and Ambient Ionization Mass Spectrometry Techniques Toward Clinical Toxicology Testing.

This review presents current scientific literature focused on chromatography-free/ambient ionization mass spectrometry techniques for clinical toxicology. Traditional methods like gas and liquid chromatography, paired with mass spectrometry, are commonly used in clinical laboratories but can be time-consuming, leading to backlogs. To alleviate workloads, immunoassays are often used for screening before confirmatory methods but are susceptible to false positives/negatives especially with structurally similar compounds. Therefore, chromatography-free ionization mass spectrometry methods could address concerns regarding uncertainty and lengthy separation. This work examines current efforts implementing these techniques along with their capabilities, limitations, and potential for future integration into clinical toxicology.