Hospital do Coração (HCor) in São Paolo, Brazil is a hospital for cardiac patients, many of whom are children and newborns. Cardiac patients are closely monitored with respect to acid base and blood gases, and even the newborns have several arterial and venous blood samples drawn daily. Dr Alberto Duarte from the...

The principal function of the protein hemoglobin contained in red blood cells is transport of oxygen in inspired air from lungs to tissue cells. Although normally present in only trace amounts, there are three species of hemoglobin that cannot transport oxygen. The three species, collectively called the dyshemoglobins ...

What does it take to create and maintain a quality point-of-care program in a world-renowned healthcare institution? acutecaretesting.org recently asked that question to Paula Santrach, MD, Interim Chair of the Dept. of Laboratory Medicine and Pathology at the Mayo Clinic in the US. She came back with a list* of 10...

One of the principal clinical uses of blood gas analysis is assessment of patient acid-base status, but over the years controversy has dogged understanding of the principles of acid-base physiology and interpretation of blood gas results.  In a brief review of the history of clinical acid-base balance, the author...

Raised serum bilirubin (hyperbilirubinemia) and consequent jaundice is common during the neonatal period; around half of all newborns become temporarily jaundiced during the first week or two of life. For the vast majority, serum bilirubin peaks no higher than around 250 µmol/L (14.6mg/dL) and jaundice quickly...

Hospital mortality rates provide information for evaluating the relative quality of the health care delivered. However, interpretation of hospital mortality rates is fraught with difficulty, not least because such bald data does not take account of the severity of the illness of patients, whose outcome is being...

The maintenance of normal blood pH depends crucially on synergy of action between lungs and kidneys, so that students of acid-base physiology must become familiar with the interrelatedness of kidney and lung function in both health and disease.  This interrelatedness is the central theme of a recently published review ...

The National Academy of Clinical Biochemistry has developed a Laboratory Medicine Practice Guideline for point-of-care testing (POCT). This POCT guideline systematically reviews the scientific literature linking POCT to patient outcome and makes recommendations for the optimal use of POCT in patient care.  This...

In Geneva in 1821, a French nobleman Jacques Alexandre Le Jumeau, Vicomte de Kergaradec, became the pioneer of modern fetal monitoring. He described the sound of the fetal heartbeat, as he used the newly invented stethoscope (by Laennec, France 1819) and applied it to the abdominal wall of a pregnant woman [1]. The...

As point-of-care testing (POCT) continues to expand in the hospital environment, the desire of physicians to participate in the performance of testing may increase. This article discusses the required competencies for a physician who wishes to be involved in laboratory testing and some practical considerations for...