Metabolic alkalosis, a disturbance of acid-base homeostasis, with many possible causes, is characterized by a primary increase in blood pH and bicarbonate (HCO₃). Hypoventilation is the compensatory respiratory response to metabolic alkalosis that results in increased pCO₂. The often complex nature of the etiology of...

Reduced blood glucose concentration (hypoglycemia) is one of the most common metabolic problems during the neonatal period. It may cause acute non-specific symptoms that include altered level of consciousness, feeding difficulties, seizures and even coma.  Irrespective of the presence or absence of acute symptoms,...

Routine laboratory assessment of renal function depends on estimating glomerular filtration rate from serum creatinine concentration. Serum creatinine concentration is age- and gender-dependent. A recently published study aimed to establish age-stratified and gender-specific reference intervals for serum creatinine...

Metformin is a widely prescribed oral antihyperglycemic drug for the long-term treatment of type 2 diabetes. It is considered a first-line drug treatment for those diabetic patients whose blood glucose remains uncontrolled by dietary and other lifestyle interventions. In addition to this established use, metformin has ...

The general truth that disturbance of acid-base homeostasis and associated abnormal blood gas results can be caused by drugs – both those prescribed and those bought over the counter, as well as those used illicitly – is reflected in a recent review article.  Metabolic alkalosis, an acid-base disturbance characterized ...

Plasma bicarbonate concentration (HCO₃^-), an essential parameter for the assessment of patient acid-base status, is routinely generated during blood gas analysis by calculation from measured pH and pCO₂. It is also directly measured by chemical analyzers in clinical laboratories that offer bicarbonate as one component ...

Blood lactate concentration, a parameter often available at the point of care on blood gas analyzers, is useful for assessment of global tissue oxygenation among acutely/critically ill patients. The ”gold standard” sample for this assessment, as for blood gas analysis, is arterial blood.  Sampling of venous blood is...

D-dimers are protein products of cross-linked fibrin degradation that are present in the blood of most healthy individuals in only negligible amounts (of the order 100-200 ng/mL). As objective evidence of increased fibrinolysis, elevated blood concentration of D-dimer is by extension evidence of intravascular...

The notion that acid-base and potassium homeostasis are linked is well known. Students of laboratory medicine will learn that in general acidemia (reduced blood pH) is associated with increased plasma potassium concentration (hyperkalemia), whilst alkalemia (increased blood pH) is associated with reduced plasma...

Increased plasma sodium concentration (hypernatremia) acquired after admission to intensive care increases the risk that critically ill patients will not survive their illness. That is the headline finding of a recently published study of ~200,000 critically patients cared for in 344 intensive care units across the US ...