Lactate measurement is important for diagnostic and prognostic assessment of the critically ill. Traditionally, lactate has been measured on serum/plasma samples in the central laboratory, but modern blood gas and other point-of-care analyzers now provide the means for real-time monitoring of lactate on whole blood at ...

Chronic obstructive pulmonary disease (COPD), a common condition of the elderly affecting an estimated 10 % of those over the age of 60 years, is characterized by an accelerated long-term decline in lung function due to inflammation-induced lung damage. Arterial blood gases are routinely used to monitor patients with...

Modern analytical devices for testing biological fluids, such as blood, have now developed a sophistication that ensures the quality of the analytical result is capable of matching that achieved in the central laboratory.    Complementary developments are focused on reducing operator-related and connectivity-related...

There are few medical diagnoses that depend solely on the result of a single blood test, but diabetes mellitus, which is defined by concentration of circulating glucose, is one that does. Quite apart from its long established role in diagnosis as well as life-long monitoring of diabetes, measurement of circulating...

Reprinted from AMERICAN JOURNAL OF CRITICAL CARE, November 2006, Volume 15, No 6, 595-599 Hudson TL, Dukes SF, Reilly K. Use of local anesthesia for arterial puncture. Copyright with permission from American Journal of Critical Care BACKGROUND Except for intravenous therapy, arterial access is the most common...

Tartu University Hospital has improved the quality of blood gas testing in its clinical laboratory and critical care units by introducing an automatic system for blood gas analysis. Not only did the quality of processes in the preanalytical phase improve, but also the automatic calculation of pO₂(A-a), for APACHE...

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...

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...

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 ...