In 2001 a landmark study demonstrated that normalization of blood glucose significantly reduces mortality and morbidity among intensive care patients. Now 5 years on, strict control of blood glucose concentration with insulin therapy is accepted as an imperative of optimal intensive care in many hospitals around the...

What does it take to create and maintain a quality point-of-care program in a world-renowned healthcare institution? acutecaretesting.org recently asked that question to Paula Santrach, MD, Interim Chair of the Dept. of Laboratory Medicine and Pathology at the Mayo Clinic in the US. She came back with a list* of 10...

Reduced blood glucose (hypoglycemia) is one of the more common metabolic emergencies during the neonatal period, which in a small minority of cases results in permanent brain damage. It remains unclear how low blood glucose concentration must fall for such devastating effect. This gray area of understanding is...

Transient hyperglycemia (raised blood glucose concentration) is a common feature of serious acute illness, including myocardial infarction. For many years, this so-called "stress hyperglycemia" was considered of little clinical significance unless it was particularly severe (blood glucose > 12 mmol/L) or associated...

Although creatinine clearance has been the mainstay for estimating glomerular filtration rate (GFR) in laboratories for the past half-century, prediction equations based on serum creatinine and other routine serum analytes are now available which enable reporting of a calculated GFR using the Modification of Diet in...

Hospital mortality rates provide information for evaluating the relative quality of the health care delivered. However, interpretation of hospital mortality rates is fraught with difficulty, not least because such bald data does not take account of the severity of the illness of patients, whose outcome is being...

"Diabetes of injury" is a term that has been used to describe the insulin resistance and resulting hyperglycemia that is a frequent feature of severe trauma and critical illness. It was once supposed that hyperglycemia is a consequence of critical illness; an adaptive, protective stress response, which is important...

Reprinted with permission from Elsevier from "Neonate capillary blood gas reference values", by Jocelyne Cousineau, Suzanne Anctil, Ana Carceller, Monique Gonthier and Edgard E. Delvin, CLINICAL BIOCHEMISTRY, Vol no 38, 2005, pp 905-907. Copyright 2005 by Canadian Society of Clinical Chemists. OBJECTIVES Because...

Laboratorians need to take ownership of errors, identifying, analyzing and reducing them, thereby increasing patient safety. A Client Services Department, customer care representatives, a service improvement coordinator, “morning report”, electronic error tracking and reporting mechanisms, point-of-care support...

Iatrogenic phlebotomy loss resulting from the intensive clinical monitoring in the weeks immediately following birth remains the primary cause of neonatal anemia and the need for red-blood-cell (RBC) transfusion. Reducing RBC transfusion needs in the neonatal intensive care unit (NICU) requires new approaches for...