Transitory increase in blood glucose concentration (hyperglycemia) is a very common feature of critical illness and severe trauma. Despite its transitory nature this hyperglycemia is associated with adverse effect and there is a consensus that critically ill patients, irrespective of their diabetic status, benefit...

Around a third of critically ill patients are given transfusion of packed red cells but there is an ever-growing body of research evidence to suggest that blood transfusion may not be as beneficial to all patients as was once supposed.  Some studies, for example, have revealed that patients given transfusion might be...

Arterial blood gas analysis is often perceived as one of the most difficult topics to be covered in the laboratory medicine curriculum, so many will welcome the promise contained in the title of this book, albeit with a degree of skepticism. They will not be disappointed. This excellent pocket-sized handbook, which...

Analytical methods are often developed at one site and transferred to other sites for routine use. Increasingly, the method development is made by manufacturers of instruments and reagents. Regulatory agencies have ruled that the responsibility for the performance of IVDs in the laboratories mainly should lie with...

When a new D-dimer method is to be implemented either as a substitute for a currently used D-dimer assay or as a supplement, maybe as a point-of-care assay, it is necessary to do a clinical comparison of the "old" assay versus the "new" assay. The major pitfalls in D-dimer comparisons are addressed in this paper.   ...

The serum (plasma) anion gap is a useful additional piece of clinical information that can be easily derived without cost from the results of the most commonly requested biochemical profile, urea and electrolytes (U&E). It is the difference between the sum of measured anions (chloride and bicarbonate) and the sum of...

Potassium is one of the blood analytes most frequently measured in the clinical laboratory and at the point of care. Compared with most laboratory measurements, potassium is unusually prone to preanalytical error so that pseudohyperkalemia, defined as raised serum or plasma potassium concentration despite normal in...

Raised blood glucose (hyperglycemia) is a common feature of critical illness associated with increased risk of death. A landmark study published in 2001 demonstrated that intensive insulin therapy directed at normalizing blood glucose significantly reduced mortality among the critically ill patient population studied. ...

Although measurement of serum lactate has an established role in the monitoring of critically ill patients at many hospitals around the world, the practice is by no means universal, reflecting a controversy that still surrounds the topic. In short there remains no consensual answer to the broad question: Should we...

Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic disturbance that results from absolute or relative insulin deficiency. It is usually precipitated by intercurrent illness and is a relatively common complication of type 1 diabetes but only rarely occurs in those suffering type 2 diabetes.  The cardinal ...