Metabolic alkalosis, a disturbance of acid-base homeostasis, with many possible causes, is characterized by a primary increase in blood pH and bicarbonate (HCO₃). Hypoventilation is the compensatory respiratory response to metabolic alkalosis that results in increased pCO₂. The often complex nature of the etiology of...

Arterial blood is the “gold standard” sample for blood gas analysis. Compared with venous blood sampling, arterial blood sampling is technically more difficult as well as being more painful and hazardous to the patient. These are among the considerations that drive the continuing research interest in establishing...

Metformin is a widely prescribed oral antihyperglycemic drug for the long-term treatment of type 2 diabetes. It is considered a first-line drug treatment for those diabetic patients whose blood glucose remains uncontrolled by dietary and other lifestyle interventions. In addition to this established use, metformin has ...

Plasma bicarbonate concentration (HCO₃^-), an essential parameter for the assessment of patient acid-base status, is routinely generated during blood gas analysis by calculation from measured pH and pCO₂. It is also directly measured by chemical analyzers in clinical laboratories that offer bicarbonate as one component ...

The notion that acid-base and potassium homeostasis are linked is well known. Students of laboratory medicine will learn that in general acidemia (reduced blood pH) is associated with increased plasma potassium concentration (hyperkalemia), whilst alkalemia (increased blood pH) is associated with reduced plasma...

In a regional top-management decision, our laboratory was given the mission to control and quality assure all POCT activities in a regional network of 10 hospitals with emergency units. Based on previous work, new region-wide recommendations, procurements,  IT connectivity, services, training, accreditation (ISO...

Normal cellular metabolism and function require that blood pH be maintained within narrow limits, 7.35-7.45. Even mild excursion outside this range has deleterious effect, and pH of less than 6.8 or greater than 7.8 is considered – according to medical and physiology texts – incompatible with life. Such a view is...

According to the nurse authors of this valuable review article, nurses working in intensive care units often have difficulty understanding the intricacies of acid-base balance as well as interpreting the results of blood gas analysis relating to the critically ill patients in their care. To address this issue and...

Patients with chronic obstruction pulmonary disease (COPD) may need long-term oxygen therapy, monitored with blood gas analysis (pO₂(a) and sO₂(a)). It is important that when adjustments are made to this therapy (either increase or decrease in fraction inspired oxygen, FIO₂) there should be delay until a new steady...

Emergency Department (ED) overcrowding is becoming an increasingly international issue.  Although the problem is not only resolved by ED change management (but rather requires a system-wide solution recognizing the complex interdependencies of consumer expectations, human resources, information systems immaturity and...