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...

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...

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...

In Geneva in 1821, a French nobleman Jacques Alexandre Le Jumeau, Vicomte de Kergaradec, became the pioneer of modern fetal monitoring. He described the sound of the fetal heartbeat, as he used the newly invented stethoscope (by Laennec, France 1819) and applied it to the abdominal wall of a pregnant woman [1]. The...

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...

This is the third in a series of four essays on www.acutecaretesting.org.  The first essay, "Quality control in theory and practice – a gap analysis", raised the question: Has “the system” given front-line laboratory workers the knowledge and tools they need to make quality control decisions wisely? Or is there a...

"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...

The National Kidney Disease Education Program (NKDEP) Laboratory Working Group reviewed problems related to serum creatinine measurement for estimating glomerular filtration rate (GFR) and prepared recommendations to standardize and improve creatinine measurement. The NKDEP recommends using the estimating equation...

Clinical initiatives to maintain blood glucose (BG) within a more normal range have emerged over the last decade as a growing trend in clinical management of patients in acute care settings. This trend has grown due to the increased focus of research in glycemic control (GC) and results indicating that GC is...