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...

Anemia and consequent need for red-cell transfusion is a common feature of critical illness. According to a recently published review of the topic, nearly all (95 %) patients who have been in an intensive care unit for longer than 3 days become anemic.  For close to 50 % of these patients, anemia is considered of...

Metformin is an oral hypoglycemic drug that has long been employed in the treatment of type 2 diabetes; it is particularly widely prescribed for those diabetics who are obese. Very rarely, metformin use results in severe lactic acidosis, most often occurring in patients with reduced renal function.  Although a very...

In health, serum potassium concentration is maintained within the approximate range of 3.5-5.2 mmol/L. Disturbance of potassium homeostasis is a common electrolyte disorder that is clinically manifest through its adverse effect on both skeletal and cardiac muscle cell function.  Although often asymptomatic, both...

Acetaminophen (alternative name paracetamol) is one of the most frequently used drugs and widely considered very safe in almost all clinical contexts so long as the maximum recommended dose is not exceeded.  When taken in overdose, however, it can cause acute liver failure (ALF). In fact, acetaminophen...

The 1999 US Institute of Medicine report "To Err is Human: Building a Safer Health Care System" provided an influential wake-up call for healthcare workers concerning the frequency of preventable medical errors. Initiatives over the past decade aimed at improving the safety of patient-sample testing represent just...

Postoperative cardiovascular event including myocardial infarction or heart failure is a major cause of morbidity after non-cardiac surgery. Preoperative evaluation including estimation of the probability of perioperative cardiac event and application of non-invasive testing or beta-blocker has been developed, but...

Point-of-care testing sites continue to increase in number due to the availability of easy-to-use devices that make it possible to provide test results very quickly relative to the central laboratory services. There is, however, mixed review regarding the accuracy and reliability of POCT results for patient care. It...

Hemodialysis and related treatments for those with failing kidneys all involve blood flow through a circuit outside the body. This extracorporeal circuit - the dialysis machine and its connections from and back to the body - is a non-physiological, pro-coagulant environment.  To counter the tendency for patients'...

Arterial blood gas analysis is used to assess and monitor patient acid-base status. Disturbance of acid-base balance is classified to one of four main types depending on the pH, pCO₂(a) and bicarbonate results generated during blood gas analysis; the four types are respiratory acidosis, respiratory alkalosis,...