Point-of-care testing provides rapid laboratory diagnostics close to the site of care. Quality assurance of POCT, however, requires significant resources that should be matched with improved patient outcome and benefit. Application of evidence-based medicine to POCT can critically assess the medical effectiveness of...

"Six Sigma" is the latest trend in quality management and is being widely implemented in business and industry today. Six Sigma represents an evolution of Total Quality Management (TQM), providing a more quantitative framework for evaluating process performance and clearer goals for process improvement. The...

In the U.S. all testing, including decentralized testing, is regulated according to the Clinical Laboratory Improvement Amendments of 1988 (CLIA'88). Congress passed CLIA'88 to ensure accurate, reliable, and timely test results regardless of test site. These quality control, quality assurance, and proficiency tesing...

In conjunction with Apgar scores and other parameters, umbilical-cord blood gas values are used to assess newborn respiratory status.  Paired umbilical-cord gas venous and arterial samples were collected from 200 patients to establish reference ranges for blood gas/hemoximetry parameters. Umbilical-cord samples were...

The application of transcutaneous pO₂/pCO₂ monitoring is essential in optimizing the ventilatory management of critically ill newborns. Application areas include high-frequency oscillatory ventilation initiation, transitioning modes of ventilation, and inter-facility transport.

Both high and low blood glucose levels may be dangerous to the newborn baby. Measurement of blood or plasma lactate concentrations gives an indication of the adequacy of oxygen delivery to tissues, and blood and CSF lactate levels are essential investigations in the diagnosis of inborn errors of metabolism (IEM)....

The intraoperative monitoring of the partial pressure of carbon dioxide in arterial blood (pCO₂) is used to assess the adequacy of ventilation and guide clinical interventions.  Although end-tidal CO₂ monitoring remains the most frequently used non-invasive technology in the intraoperative setting to provide a...

Babies are not small adults! The potential for abnormal adaptation to life outside of the womb, changes in physiology, and a myriad of possible life-threatening clinical conditions requires an understanding of the laboratory tests needed to support these infants.  To effectively handle the unique needs of these...

Electronic fetal monitoring (EFM) during labor has been performed for 40 years. However, the specificity in diagnosing asphyxia is still insufficient. The combination of EFM and fetal scalp-blood sampling was introduced shortly after the introduction of EFM.  Although this monitoring ensures a better sensitivity and...

Children are not just small adults, and present unique challenges to the clinical laboratory. Blood specimens must be very small; for example, total blood volumes in a premature infant can be as small as 115 mL. Genetic diseases frequently must be detected in the newborn period. Reference values change with age....