Respiratory acidosis and alkalosis are characterized by primary change in pCO₂ (increase in the case of acidosis and decrease in the case of alkalosis). Secondary physiological compensation, aimed at returning blood pH to normal, is evident in blood gas results as a change in bicarbonate concentration (increase in the ...

Transient increase in serum bilirubin concentration is a normal physiological feature of the neonatal period and this rise is sufficient to cause visible jaundice in around 60 % of newborns. For most the condition is harmless and resolves spontaneously with no long-term effects. However for those neonates with...

Reduced plasma sodium concentration (hyponatremia), the most common electrolyte abnormality in hospitalized patients, is the subject of a recently published review. Disordered secretion of the pituitary hormone vasopressin (alternative name, antidiuretic hormone ADH) is central to the pathogenesis of hyponatremia for...

Critically ill patients often require frequent monitoring of blood gases and the arterial blood required for these analyses is most conveniently sampled via an indwelling arterial catheter; arterial catheterization also provides the means for continuous monitoring of blood pressure.  Of all the invasive procedures...

Umbilical cord blood gas analysis has for many years been recommended for assessment of newborn babies after high-risk delivery associated with possible hypoxic stress and consequent risk of permanent brain damage. More recently there has been an increasing trend towards its routine use after all deliveries.  With...

Reduction in platelet numbers (thrombocytopenia) is associated with reduced hemostatic response to blood-vessel injury and therefore increased risk of bleeding. In health, the concentration of platelets in peripheral blood is maintained within the range of 150-400 × 10³/mL. The risk of spontaneous life-threatening...

Lactate measurement is important for diagnostic and prognostic assessment of the critically ill. Traditionally, lactate has been measured on serum/plasma samples in the central laboratory, but modern blood gas and other point-of-care analyzers now provide the means for real-time monitoring of lactate on whole blood at ...

Chronic obstructive pulmonary disease (COPD), a common condition of the elderly affecting an estimated 10 % of those over the age of 60 years, is characterized by an accelerated long-term decline in lung function due to inflammation-induced lung damage. Arterial blood gases are routinely used to monitor patients with...

As with any aspect of healthcare, laboratory testing is prone to errors that may have a negative impact on outcome for patients. The focus for laboratory management in this regard has not unnaturally been the analytical process with great emphasis placed on the value of internal and external quality control programs...

Hospitalized patients are frequently prescribed parenteral fluids and in most instances these are hypotonic (e.g. 0.18 % NaCl in 5 % dextrose). Controversy surrounds the routine use of hypotonic parenteral fluids because they can cause hyponatremia (reduced plasma sodium concentration), which if sufficiently severe...