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Journal scans
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Journal Scan
August 2018
A novel use of serum bilirubin measurement investigated
Bilirubin is a product of the hemoglobin catabolism that occurs principally in the spleen where red cells (that contain hemoglobin) are sequestered at the end of their approximate 120-day life. Bilirubin is transported in blood from the spleen to the liver where it is eliminated from the body in bile. Serum bilirubin...
Bilirubin
Journal Scan
August 2018
Vitamin D toxicity – a very rare cause of increased plasma calcium
In health total plasma calcium concentration is maintained within the approximate reference range of 8.8-10.5 mg/dL (2.20-2.62 mmol/L) so that raised plasma calcium (hypercalcemia) is usually diagnosed if plasma calcium is >10.5 mg/dL (>2.62 mmol/L) and severe, potentially life-threatening hypercalcemia is roughly...
Electrolytes
Journal Scan
July 2018
Life-threatening metabolic acidosis – a case study report
In health, blood pH is maintained within a narrow reference range, 7.35-7.45. Medical texts discussing general aspects of acid-base disturbance frequently include the observation that pH <6.8 is inevitably fatal. However, there are individual case reports of survival despite this degree of extreme acidosis. One such...
Blood gases/acid-base
Lactate
Journal Scan
July 2018
Understanding the symptoms and clinical significance of reduced plasma/serum sodium (hyponatremia)
Reduced plasma/serum sodium (hyponatremia), widely defined as plasma/serum sodium
Mild hyponatremia, i.e. plasma/serum sodium in the approximate range of 130 to 136 mmol/L, is usually not associated with symptoms, but most patients whose plasma/serum is
Explanation of these effects of hyponatremia is contained in...
Electrolytes
Kidneys/fluids
Journal Scan
March 2018
Albumin adjustment of total calcium not justified
Almost all (99 %) of the approximate 1 kg of calcium in the adult human body is contained in bone, but a small fraction (approximately 350 mg) circulates in blood plasma at a concentration of around 2.5 mmol/L. This circulating calcium comprises three fractions: around half (50 %) is free ionized calcium; the rest is...
Preanalytical phase
Process optimization
Journal Scan
March 2018
Ketoacidosis – three unusual and informative case study reports
Blood gas analysis involves determination of three parameters (pH, bicarbonate and partial pressure of carbon dioxide, pCO2) necessary for assessment of patient acid-base status and identification of those whose acid-base is disturbed. There are four classes of acid-base disturbance: metabolic acidosis, metabolic...
Blood gases/acid-base
Electrolytes
Journal Scan
February 2018
Diagnosis and management of sepsis/septic shock – a review article
As the authors of this recently published review article acknowledge, sepsis is an increasingly common and serious illness that takes the lives of close to a third of those affected. Optimal care of patients with sepsis is delivered in an intensive care unit but rapid early diagnosis, vital for survival, occurs...
Blood gases/acid-base
Hemoglobins
Journal Scan
February 2018
In vitro hemolysis – a potential cause of preanalytical error reviewed
The process of laboratory/point-of-care testing of patient samples comprises three distinct phases: the preanalytical phase, which includes sample collection and transport to the site of testing; the analytical phase; and the postanalytical phase, which includes communication and interpretation of the test result as...
Electrolytes
Journal Scan
January 2018
Blood sampled from bone for point-of-care testing
Intravenous (iv) catheters are routinely employed for speedy delivery of fluids and drugs to the critically ill; they also provide the means for sampling blood for testing. This iv catheterization occurs in a range of settings including prehospital emergency care, hospital emergency rooms and intensive/critical care...
Electrolytes
Journal Scan
January 2018
Acid-base and electrolyte disturbance in chronic kidney disease – a themed issue review
As the site of production of the hormones: renin, erythropoietin and calcitriol that regulate, respectively, blood pressure, erythrocyte (red blood cell) production and absorption of dietary calcium, the kidneys have significant and disparate endocrine function. Additionally, of course, the kidneys have an excretory...
Blood gases/acid-base
Preanalytical phase
Process optimization
Quality assurance