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Journal Scan
October 2010
Challenging intensive care policy
In the intensive care unit blood is frequently sampled for arterial blood gases via an indwelling arterial catheter. Around a third of critically ill patients have such catheters inserted; they allow not only easy access for blood sampling but also continuous monitoring of blood pressure. In a short editorial the...
Quality assurance
Preanalytical phase
Journal Scan
October 2010
Metformin toxicity
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...
Blood gases/acid-base
Lactate
Journal Scan
July 2010
Plasma sodium concentration in the critically ill
Of all blood chemistry parameters, sodium is one of the most frequently measured among hospitalized patients, including those admitted to critical care units. The assay is generally available on point-of-care analyzers sited in these units. Incidence of abnormality in plasma sodium concentration among critically ill...
Electrolytes
Journal Scan
July 2010
Hypoglycemia in the critically ill
Raised blood glucose (hyperglycemia) is a common feature of critical illness, irrespective of diabetes status. A landmark Belgian study conducted in 2001 demonstrated that this hyperglycemia is associated with increased morbidity and mortality. As a result of that study maintenance of normal blood glucose, with...
Glucose
Journal Scan
July 2010
Pseudo-hypoxemia
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...
Blood gases/acid-base
Quality assurance
Preanalytical phase
Journal Scan
July 2010
Umbilical cord blood gas analysis
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...
Blood gases/acid-base
Neonatology
Journal Scan
July 2010
An unusual case of severe (fatal) metabolic acidosis
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 ...
Blood gases/acid-base
Journal Scan
April 2010
Ion-selective electrode interference - a review
Plasma electrolytes, which include sodium, potassium, chloride, calcium and magnesium, are among the most frequently measured blood analytes in clinical medicine. All are measured by ion-selective electrodes (ISE). ISEs are present not only in clinical laboratory instrumentation but also in blood gas analyzers and...
Electrolytes
Point-of-care testing
Journal Scan
April 2010
Nurse-led intensive insulin therapy is safe and effective
Transitory increase in blood glucose concentration (hyperglycemia) is a very common feature of critical illness and severe trauma. Despite its transitory nature this hyperglycemia is associated with adverse effect and there is a consensus that critically ill patients, irrespective of their diabetic status, benefit...
Glucose
Journal Scan
April 2010
Infection - a downside of blood transfusion therapy
Around a third of critically ill patients are given transfusion of packed red cells but there is an ever-growing body of research evidence to suggest that blood transfusion may not be as beneficial to all patients as was once supposed.
Some studies, for example, have revealed that patients given transfusion might be...
Infection/sepsis