Metformin, a blood-glucose-lowering drug widely used for treatment of type 2 diabetes, is associated with risk of potentially fatal metabolic (lactic) acidosis. This can occur not only following overdose but also at therapeutic dose in patients with pre-existing renal or liver disease. Results of arterial blood gas...

If the results of a recent New Zealand study are representative, there is room for improvement in the quality of blood gas test result interpretation among emergency-room medical staff. A total of 80 emergency-room doctors (37 consultants and 43 emergency-medicine trainees) voluntarily submitted themselves for a...

Metabolic acidosis, the most common disturbance of acid-base balance among the critically ill, is characterized by arterial blood gas results that reveal primary decrease in bicarbonate and compensatory decrease in pCO₂(a). Blood pH is reduced unless respiratory compensation is complete. It is most often the result of ...

The prognostic value of measuring umbilical cord blood pH at birth is examined in a recent meta-analysis study. Cord blood acidosis (usually defined as cord blood pH <7.0) is considered evidence that the newborn baby was deprived of oxygen during labor, and in some maternity units cord blood pH is used in the...

Arterial blood gas analysis includes measurement of partial pressure of oxygen (pO₂(a)) and calculation of oxygen saturation (sO₂(a)), both useful for assessing patient oxygenation status. Hypoxemia is diagnosed if pO₂(a) is below the lower limit of the reference range (10.6 kPa, 88 mmHg). Pseudo-hypoxemia is...

BACKGROUND: Besides actual pH, base excess (ctH⁺_B (mmol/L)) is of major importance since it is meant to reflect lactate acidosis due to fetal hypoxia; in vivo BE_B is not independent from pCO₂. Independence is achieved by using the extended extracellular fluid (Ecf) for dilution of hemoglobin (cHb_B), reducing cHb_B to ...

Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance?  Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...

Arterial blood gas analysis is often perceived as one of the most difficult topics to be covered in the laboratory medicine curriculum, so many will welcome the promise contained in the title of this book, albeit with a degree of skepticism. They will not be disappointed. This excellent pocket-sized handbook, which...

The significance of preanalytical technique for accurate arterial blood gas analysis is the focus of a recently published study. The authors of this study sought to quantitate the analytical error associated with collection of venous rather than arterial blood, delay in arterial blood analysis and contamination of...

The serum (plasma) anion gap is a useful additional piece of clinical information that can be easily derived without cost from the results of the most commonly requested biochemical profile, urea and electrolytes (U&E). It is the difference between the sum of measured anions (chloride and bicarbonate) and the sum of...