This is the second of two articles focusing on the reference interval, the most widely used tool for interpretation of patient test results.  The first [1] was an introduction to the theoretical concepts that underpin the significance, construction and use of reference intervals. Here consideration is given to the...

As point-of-care applications of lab testing demand more rapid and clinically integrated order entry and results-reporting processes, it becomes paramount for the laboratory to investigate entire clinical processes. Direct observation and process mapping of these clinical applications – end to end - are "lean" tools...

Applications of point-of-care testing (POCT) for diagnostic biomarker measurement in healthcare have increased significantly in recent years in a wide range of clinical scenarios. These include infectious disease, critical care, cardiology and other areas of emergency medicine. Traditionally, routine clinical...

Timely and accurate diagnosis of sepsis is of great importance for the choice of treatment, level of monitoring and prognosis. For this biomarkers could be a significant aid, and thus the search for and application of sepsis biomarkers are of great importance.  Current evidence suggests that C-reactive protein and...

All newborn babies have, by comparison with adults, a raised serum concentration of unconjugated (and therefore total) bilirubin, due principally to the transient increase in red cell destruction associated with the move from intrauterine support to physiological independence.  In close to half of all newborns the...

The factors that influence critical care nursing staff when making the decision to sample blood for arterial blood gas analysis is the subject of a recent UK study. The authors of this study specifically sought to establish if there is an association between patient values for four parameters (FO₂(I) , pCO₂, pO₂ and % ...

Over a third of patients admitted to intensive care develop hypernatremia (raised serum sodium concentration) or hyponatremia (reduced plasma sodium concentration) within a few days of admission. Both hypo- and hypernatremia acquired after admission prolong hospital stay and decrease chance of survival.  These are the ...

Metabolic acidosis is the most common disturbance of acid-base balance among the critically ill of all ages, usually due to increased lactate production consequent on inadequate tissue perfusion and/or hypoxemia. The condition is characterized by primary reduction in bicarbonate and pH revealed during arterial blood...

The anticoagulant potassium ethylenediaminetetra-acetic acid (K+ EDTA) is present in sample tubes used to collect samples for full blood count (FBC) and some other tests. However, the anticoagulant has the effect of markedly increasing plasma potassium concentration and reducing plasma calcium, magnesium and zinc...

In an exclusive acutecaretesting.org interview, Dr Mario Plebani, Head of the Department of Laboratory Medicine at the University Hospital of Padova, Italy and international patient safety advocate, talks about how laboratory, clinicians and manufacturers can work together to reduce errors in testing and diagnosing...