This first of two articles on understanding the clinical value of measuring urea concentration dives into the physiological topics, such as urea production and renal processing of urea as well as the causes of increased and reduced urea concentration. Kidney disease is associated with reduced urea excretion and...

Diabetic ketoacidosis (DKA), which is an acute, potentially life-threatening complication of poorly controlled diabetes, is the subject of a recent comprehensive review article.   The authors discuss epidemiological issues, revealing increasing incidence of DKA and decreasing mortality.  Once inevitably fatal, DKA...

In regulating blood bicarbonate concentration the kidneys play a central role in acid-base homeostasis, and severe renal failure causes metabolic acidosis. This is a disturbance of acid-base characterized by primary reduction in blood bicarbonate and pH, and secondary (compensatory) decrease in pCO₂. One of the aims...

Three parameters generated during blood gas analysis, pH, pCO₂ and bicarbonate, provide the means for assessment of patient acid-base status, which is frequently disturbed in the acutely/critically ill. Four broad classes of acid-base disturbance are recognized: metabolic acidosis, respiratory acidosis, metabolic...

When a new D-dimer method is evaluated, it’s typically compared to an established D-dimer method using both an analytical and a clinical comparison. Analytical comparisons should be discouraged, as they do not give any useful information about the potential clinical usability of the assay. D-dimer assay comparisons...

The measurement of the parameters pH, pCO₂ and pO₂ is vulnerable to a number of preanalytical errors and this article shares practical tips to help avoid these errors, ensuring that the results of analysis accurately reflect the patient’s acid-base and oxygenation status. The tips include the removal of air bubbles, ...

This recently published case study report provides a reminder that blood gas analysis plays an important role in the emergency room assessment of unconscious patients and that disturbance of acid-base homeostasis can be attributable to ingestion of toxic chemicals. The case concerns a 37-year old non-insulin dependant ...

Cardiac troponin T (cTnT) is the biomarker of choice for diagnosis of acute coronary syndromes (myocardial infarction (MI) and unstable angina). The cardiac muscle cell (myocyte) necrosis, consequent on ischemia that characterises MI, results in release of troponins from necrosed cardiac myocytes to blood and rising...

The D-dimer blood test is a clinical laboratory test that is also increasingly available at the point of care, most often the hospital emergency room. Over the past decade or so the test has become established for emergency room assessment of patients suspected of suffering deep vein thrombosis or pulmonary embolism,...

Blood gas analysis involves measurement of three parameters: pH, partial pressure of carbon dioxide (pCO₂) and partial pressure of oxygen (pO₂). Derived (calculated from these measured values) parameters also generated during blood gas analysis include: bicarbonate (HCO₃) concentration, base excess (BE) and oxygen...