Plasma bicarbonate concentration, a parameter generated during arterial blood gas analysis, is essential to the assessment of patient acid-base status. Blood gas analyzers do not have the capacity to directly measure bicarbonate; instead, it is calculated from measured pH and pCO₂(a), using the Henderson-Hasselbalch...

Diabetic ketoacidosis (DKA), a common acute and potentially life-threatening complication of diabetes that results from insulin deficiency, is characterized by raised blood glucose (hyperglycemia) and metabolic acidosis. Metabolic acidosis occurs due to abnormal accumulation in blood of ketoacids, principally...

Serum bilirubin estimation, which has for some years now been available on point-of-care analyzers, including blood gas analyzers, is probably the most frequently requested blood test in neonatal medicine.  This is because increased serum/plasma bilirubin concentration (hyperbilirubinemia) and consequent jaundice is...

Although arterial blood remains the gold standard sample for blood gas analysis, it is, compared with peripheral venous blood, a more difficult sample to obtain, and its collection is more painful and hazardous for the patient. These considerations have fuelled a growing interest in study aimed at establishing if...

Arterial blood gas (ABG) analysis generates a number of parameters (listed in BOX 5) that together allow assessment of pulmonary gas exchange, blood oxygenation and acid-base balance. These physiological functions of the blood, respiratory and renal systems are disturbed in a range of respiratory and non-respiratory...

A new parameter called critical reference change value (CrRCV) to be applied for the interpretation of serial measurements of cardiac troponin I (cTnI) is introduced. To illustrate the practical utility of CrRCV a set of clinical examples based on two consecutive cTnI results are presented. Thus three cTnI changes...

In the ED, 25 % of patients with angina pectoris with suspected AMI are wrongly diagnosed (no cardiac involvement). As a result, the patient risks are increased and resources are wasted. We investigated the effect of point-of-care testing (POCT) on ED processes, resource needs, patient risks and overall costs. POCT...

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...

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...