The integrity and function of all cells depend on an adequate supply of oxygen. Severe acute illness is frequently associated with inadequate tissue perfusion and/or reduced amount of oxygen in blood (hypoxemia) leading to tissue hypoxia.  If not reversed, tissue hypoxia can rapidly progress to multiorgan failure and ...

In health no more than 1-2 % of total hemoglobin is present as methemoglobin. This is a dysfunctional form of hemoglobin that is unable to bind and transport oxygen because the iron atom of the heme moiety is in the ferrous rather then the normal ferric state. Abnormal increase in methemoglobin, a condition called...

As with any aspect of healthcare, laboratory testing is prone to errors that may have a negative impact on outcome for patients. The focus for laboratory management in this regard has not unnaturally been the analytical process with great emphasis placed on the value of internal and external quality control programs...

Hospitalized patients are frequently prescribed parenteral fluids and in most instances these are hypotonic (e.g. 0.18 % NaCl in 5 % dextrose). Controversy surrounds the routine use of hypotonic parenteral fluids because they can cause hyponatremia (reduced plasma sodium concentration), which if sufficiently severe...

Increased serum bilirubin (hyperbilirubinemia) and consequent jaundice are common during the neonatal period. Around 50 % of newborns develop some degree of jaundice, during the first week of life, but for the vast majority this is mild (serum bilirubin peaking no higher than 150-200 µmol/L) and spontaneously resolves ...

Arterial blood is the standard sample for blood gas analysis but arterial blood sampling is more painful and hazardous to the patient. Such is the relative convenience and safety of sampling venous blood that several studies have sought to investigate the validity of its use as a substitute for arterial blood.  The...

In 2005, acutecaretesting.org interviewed Dr Michael Astion, an active spokesperson for patient safety and reduction of lab errors, on the main issues surrounding the topic. Since then, a lot has changed… or has it? In a follow-up interview with Astion, acutecaretesting.org gauges the status of patient safety year...

This essay is a follow-up to the 2006 series expressing concern that there is a widespread gap between QC theory and QC practice. Now we are giving you, the reader, the opportunity to rate your own QC practice and to help prove or disprove that gap.  If the QC theories generally recommended by recognized QC experts ...

Plasma sodium and chloride concentration are routinely measured using either a direct or indirect ion-specific electrode (ISE). Direct ISE is the technique employed in blood gas and most other point-of-care analyzers whereas indirect ISE is used in the majority of biochemistry profiling analyzers sited in central...

Results of hemoglobin (Hb) and hematocrit (Hct) measurement are routinely used to assess blood loss among trauma patients. But is it necessary to measure both parameters and if not, is one more reliable than the other? There is evidence to suggest that many physicians believe hematocrit is a more sensitive indicator...