Carboxyhemoglobin (COHb) is the product of the reaction between hemoglobin and carbon monoxide, and measurement of COHb is used in the diagnosis of carbon monoxide poisoning. Since carbon monoxide is a common pollutant present in cigarette smoke and car exhaust, it is difficult to be too dogmatic about what...

When blood gas analysis reveals a reduced pO₂(a) in a patient without any immediate clinical evidence of hypoxemia, consideration should be given to the possibility that the result is falsely low, allowing a diagnosis of spurious or pseudo-hypoxemia.  Technical deficiencies (e.g. sampling of venous rather than...

The introduction of new clinical procedures may have unanticipated adverse effects. The rising incidence of nosocomial infection has highlighted a critical need for effective hand hygiene among healthcare workers. During the past five years there has been increasing acceptance by health authorities of the...

The standard sample for measurement of blood gases is arterial blood. Arterial puncture is painful and, because of inherent dangers, is usually only performed by qualified medical staff. Arterialized earlobe capillary blood sampling provides a less painful and safer alternative, which can be reliably performed after...

In health, plasma potassium is maintained within the range of 3.5-5.2 mmol/L. Marked increase in potassium level (> 6.5 mmol/L) is considered a clinical emergency because it is associated with high risk of cardiac arrhythmia and, ultimately, cardiac arrest. Collective clinical experience suggests that in the absence...

Investment in medical research is expected to have a payback; we assume that with the passage of time increased knowledge and understanding of disease process will inevitably lead to improved treatment and better outcome. This optimistic paradigm has proved valid for some of the major killer diseases, including heart...

The results of the above trial suggest that administration of rFVIIa would reduce patient exposure to the perils of blood-product transfusion, which are only now being fully recognized.  Increased awareness of the morbidity and mortality associated with transfusion of blood products has led to the implementation of...

Assessment of patient acid-base status is one of the principal uses of arterial blood gas analysis. Disturbance of acid-base, usually the result of abnormal accumulation of metabolic acids, most notably lactic acid, is a relatively frequent finding among critically ill patients.  Base deficit (BD), a blood gas...

Hailed by UK diabetic expert Professor Harry Keen as "one of the most important studies ever done for people with diabetes" when it was published in 1993, this influential clinical study was conducted by the Diabetes Control and Complications Trial Research Group (DCCT).  It settled once and for all a debate that had...

Massive hemorrhage is a major cause of morbidity and mortality among critically ill patients. Conventional treatment is based on surgical control of bleeding and transfusion of blood products including red cells, platelets and fresh frozen plasma. Despite optimal conventional care, bleeding sometimes proves impossible ...