Emergency departments (ED) are challenged by increasing patient visits, overcrowding and prolonged length of stay (LOS). The cause of these problems is multifactorial. Delays in the laboratory are often perceived as contributing to delays in care and increased LOS. Implementation of selected point-of-care tests in...

Various guidelines and recommendations are available for the use of natriuretic peptides in the diagnosis of heart failure. As it is known that old age may lead to higher natriuretic peptide values in the absence of heart failure, it is relevant to decide whether to use age-dependent reference intervals for clinical...

The necessary administration of image-enhancing agents to patients prior to radiological investigation is associated with risk of two serious adverse effects: nephrogenic systemic fibrosis (NSF) and contrast-induced nephropathy (CIN). The risk only applies to those patients with renal disease, either acute kidney...

For a number of years point-of-care blood lactate measurement has been used to predict outcome for patients suffering a range of critical illnesses. Now a recently published study suggests that this predictive value of lactate measurement can also be usefully applied to very-low-birth-weight (VLBW) neonates born...

Many hospitals have a pneumatic tube system (PTS) that is routinely used to transport blood samples rapidly to the central laboratory, but the notion that such systems can be used to transport samples destined for blood gas analysis is challenged by the results of a recent study.  This prospective study, focusing on...

Metabolic alkalosis is a disturbance of acid-base balance, with many possible causes, characterized by primary increase in blood bicarbonate (HCO₃) and pH. Hypoventilation is the normal compensatory respiratory response to metabolic alkalosis. This results in increased pCO₂ and, if the metabolic alkalosis is...

In health plasma potassium concentration is maintained between 3.5 and 5.2 mmol/L. The most significant clinical effect of both raised plasma potassium (hyperkalemia) and reduced plasma potassium (hypokalemia) is on the myocardium (heart muscle).  This reflects the fact that the resting membrane potential of cardiac...

Patients with sepsis, severe sepsis and/or septic shock are at increased risk of death and organ dysfunction.  While morbidity and mortality of patients with severe traumatic injury, acute myocardial infarction or stroke have been significantly reduced during recent years by the implementation of well-coordinated...

Blood gas analysis (BGA) is a laboratory and point-of-care test routinely used to assess acid-base status along with adequacy of ventilation and oxygenation among predominantly critically/acutely ill patients.  The ”gold standard” sample for BGA is arterial blood collected anaerobically by needle puncture of an artery ...

Blood gas analysis (BGA) provides the means for the most accurate assessment of patient oxygenation status; the two relevant blood gas parameters being partial pressure of oxygen in arterial blood (pO₂(a)), and % hemoglobin oxygen saturation (sO₂(a)).  Pulse oximetry, a technology now ubiquitous in all areas of...