Acute kidney injury (AKI) is defined as an abrupt decrease in kidney function evidenced by recent (within 48 hours) increase in serum creatinine concentration equal to or greater than 26.5 µmol/L (0.3 mg/dL). It can be a complication of many conditions that warrant hospital admission so it is common; up to 20 % of...

Measurement of serum lactate is increasingly being used in the assessment of emergency department (ED) patients. The prognostic significance of raised lactate (hyperlactatemia) at ED admission is the subject of a recent study conducted at the ED of a secondary and tertiary referral teaching hospital located in the...

The gold standard sample for blood gas analysis is arterial blood. Compared with collection of venous or capillary blood, collection of arterial blood by arterial puncture is a painful procedure that can induce feelings of anxiety. The notion that this pain and anxiety could be a source of preanalytical error in blood ...

In health plasma ionized calcium concentration (iCa) is maintained within the approximate reference range of 1.15-1.30 mmol/L (4.6-5.2 mg/dL) principally by the synergistic action of two hormones: parathyroid hormone (PTH) and the vitamin D-derived hormone, calcitriol.  Hypercalcemia (increased blood calcium),...

Monitoring patient acid-base status is one of three principal clinical utilities of blood gas analysis (the other two are monitoring patient oxygen and ventilation status). Three parameters generated during blood gas analysis (pH, pCO₂ and bicarbonate) allow this acid-base assessment and classification of all...

It is widely acknowledged that the majority of errors in clinical laboratory and point-of-care testing occur during the preanalytical phase. Blood collection (phlebotomy) is an element of the preanalytical phase particularly prone to potential error, so that adherence to authoritative (evidence-based) recommendations...

In health plasma potassium concentration is maintained within the approximate reference range of 3.5-5.2 mmol/L, so that hypokalemia (reduced plasma potassium) is defined as plasma potassium < 3.5 mmol/L.  Mild hypokalemia (plasma potassium in the range of 3.0-3.5 mmol/L) is a common electrolyte disturbance that may or ...

Blood gas analysis involves three measurements: blood pH, partial pressure of carbon dioxide in blood plasma (pCO₂) and partial pressure of oxygen in blood plasma (pO₂). The first two, pH and pCO₂ along with other derived (calculated) parameters (bicarbonate, base excess) generated during blood gas analysis allow...

Nationwide harmonization of clinical laboratory practice is a stated strategic goal of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM). In 2013, a CSMBLM working group conducted a nationwide survey of all aspects of blood gas testing practice in Croatian hospital laboratories.  This...

The blood gas analyzer has an established role in the delivery suite of obstetric units. Measurement of umbilical cord blood pH and base excess provides objective evidence of the metabolic condition of newborn babies at the moment of birth.  Specifically, it allows identification of those with significant metabolic...