This article explores the potential benefits of point-of-care testing in the ED. Price and St. John provide a detailed description on how to approach four common aspects of point-of-care testing (POCT) in the ED, specifically, the challenges of adopting POCT, the impact of POCT on clinical decisions, the impact of...

Summary The reference interval for a biochemical analyte is usually an interval of values bounded by the reference limit values at certain designated percentiles [1].  As always when choosing a cut-off, the value will determine the trade-off between clinical sensitivity and specificity. When a low cut-off is chosen,...

This paper is an up-to-date account of research and current clinical practice guideline recommendations. Chris Higgins summarizes the recommendations of 2 new guidance documents on the use of natriuretic peptides in heart failure. The first document is a systematic review of published research (up to 2016) on the role ...

This article reviews the results of recent clinical studies on measuring lactate in arterial versus capillary blood. While arterial blood is the gold standard sample for lactate measurement on blood gas and other point-of-care analyzers, capillary blood is an alternative sample for lactate measurement on hand-held...

This article discusses the use of a D-dimer assay in excluding venous thromboembolism (VTE) in outpatients. Together with a low pretest probability of VTE, a negative D-dimer test can rule out VTE in 30-50 % of suspected patient cases. The article highlights the importance of using a D-dimer assay with particular...

This article discusses the use of citrate anticoagulation during continuous renal replacement therapies (CRRTs) which are prescribed for patients with severe acute kidney injury (AKI). Where heparin was traditionally the anticoagulant of choice for CRRT, regional citrate anticoagulation (RCA) has now emerged as the...

Reprinted with permission from Biochemia Medica. The journal of Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochemia Medica 2016;26(3):318-36  Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory...

This article demonstrates that adding a lot of patients without disease and with low test results to a study may improve the ROC curve significantly without any improvement in sensitivity or in positive predictive value of the parameter evaluated. The precision-recall curves are not impacted by the addition of...

This article evaluates venous blood as an alternative to arterial blood for lactate measurement, highlighting the general considerations related to each of the three types of venous blood which can be used for lactate measurement: peripheral venous blood, central venous blood and mixed venous blood.

Procalcitonin (PCT) is a biomarker which is elevated in bacterial infection. Usefulness of PCT measurements in community-acquired pneumonia (CAP) has to be proven by many studies. A single measurement of PCT on admission or outpatient visits is useful to diagnose CAP, estimate causative pathogens pattern, and for...