Raised blood glucose (hyperglycemia) is a common feature of critical illness, irrespective of diabetes status. A landmark Belgian study conducted in 2001 demonstrated that this hyperglycemia is associated with increased morbidity and mortality. As a result of that study maintenance of normal blood glucose, with...

Arterial blood gas analysis includes measurement of partial pressure of oxygen (pO₂(a)) and calculation of oxygen saturation (sO₂(a)), both useful for assessing patient oxygenation status. Hypoxemia is diagnosed if pO₂(a) is below the lower limit of the reference range (10.6 kPa, 88 mmHg). Pseudo-hypoxemia is...

PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward. DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward. FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...

The growing role of cardiac markers has been elucidated in patients with acute coronary syndrome, heart failure and other cardiovascular diseases. The markers can be cytosolic like heart-type fatty-acid-binding protein (H-FABP) and creatine kinase MB (CKMB), myofibrillary like troponin T (TnT) and cardio-endocrine...

BACKGROUND: Besides actual pH, base excess (ctH⁺_B (mmol/L)) is of major importance since it is meant to reflect lactate acidosis due to fetal hypoxia; in vivo BE_B is not independent from pCO₂. Independence is achieved by using the extended extracellular fluid (Ecf) for dilution of hemoglobin (cHb_B), reducing cHb_B to ...

The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2. Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT). More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...

Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance?  Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...

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...

The significance of preanalytical technique for accurate arterial blood gas analysis is the focus of a recently published study. The authors of this study sought to quantitate the analytical error associated with collection of venous rather than arterial blood, delay in arterial blood analysis and contamination of...