Blood gases are measured from an arterial blood sample to evaluate the respiratory adequacy and oxygen status of the critically ill patient. For the adult patient, the arterial blood is sampled either by arterial puncture or from an indwelling catheter. In neonates and children, the wish to minimize iatrogenic blood...

The collection of arterial specimens with glass syringes and immediate storage in iced water was the accepted industry standard for many years. Practice has changed over the past several years to blood gas sample collection in plastic syringes, likely due to the cost, safety and convenience of plastic. This change ...

Five years of data on percutaneous injuries (PIs) from the EPINet multi-hospital sharps injury database at the University of Virginia were analyzed to understand exposure risks faced by personnel in intensive care/critical care settings. Of 687 PIs in intensive care units (ICUs), nurses had the highest proportion of...

Can blood gas results be used to predict respiratory failure in victims of severe trauma? Many such patients present with metabolic acidosis, invariably the result of increased lactic acid production due to hemorrhagic shock. The normal physiological (compensatory) response to preserve a normal pH in those with...

Mechanical ventilation is normally adjusted so that pCO2 is maintained within normal limits (35-45 mmHg). However, the intensity of ventilation required to sustain a normal pCO2 can cause mechanical damage to the lungs of patients with acute respiratory distress syndrome (ARDS).  One of the strategies used to minimize ...

Venous blood is an acceptable alternative to arterial blood for estimation of bicarbonate by blood gas analysis, according to the results of a recently published Australian study. Over a six-month study period, clinicians at the Emergency Department of Western Hospital in Melbourne simultaneously sampled venous and...

Disturbance of normal acid-base balance is a defining feature of diabetic ketoacidosis (DKA), the acute and potentially life-threatening complication of diabetes that results from severe insulin deficiency. The cause of the acidosis in such cases is abnormal accumulation in blood of the two ketoacids, acetoacetate and ...

Oxygen is one of the most widely used drugs in medicine, and especially so in the newborn period. In many cases, oxygen supplementation is needed and is life-giving, but we are also aware of its toxic effects. In spite of this, we still do not know exactly what is the correct way to administer this drug. It is a...

The significance of good practice during the pretesting phase of clinical laboratory investigation cannot be overemphasized. The production of high-quality, accurate results, which are clinically useful, depends as much on practice before the patient’s sample reaches the laboratory as it does on the analytical phase...

Neonatology, perhaps more than any other field in medicine, has undergone dramatic improvements in care over the last several decades. One of the main areas of advancement is the ability to mechanically ventilate premature infants with a variety of neonatal lung conditions. As survival of premature infants has...