Clinical laboratory test results are a very important parameter in diagnosis, monitoring and screening. 70-80 % of decisions in diagnosis are based on laboratory results and more and more laboratory analyses are requested. Thus a lot of data are provided and it is therefore imperative for patient care (and safety)...

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 ...

Critical values are those associated with imminent danger unless acted upon promptly. Critical value menus often include results that do not fit this definition, leading to highly variable practice in adult and pediatric laboratories. Existing menus may be subdivided into more uniform tiers of severity: the highly...

In recent years there has been increasing interest in the significance of the transitory raised blood glucose (hyperglycemia) that very often occurs in individuals suffering critical illness and trauma. A number of studies have shown an association between hyperglycemia and poor outcome. Knowledge in this area is...

No history of the development of blood gas analysis and its application in clinical and physiology research would be complete without consideration of the pioneering work of anesthesiologist researcher Dr John Severinghaus.  As a young research fellow in the 1950s he developed the Stow-Severinghaus-type carbon dioxide ...

As a global marker of tissue oxygenation serum lactate measurement has proven its usefulness in monitoring the critically ill. It has also proved useful as a screening tool for sepsis in the emergency room.  However, lactate measurement is not always readily available. Increased lactate is a common cause of raised...