Critical values are those associated with imminent danger unless acted upon promptly. Critical value menus often include results that do not fit this definition, leading to highly variable practice in adult and pediatric laboratories. Existing menus may be subdivided into more uniform tiers of severity: the highly...

Neonatal jaundice is the subject of two recent studies and an accompanying editorial, all published in the October issue of Archives of Disease in Childhood (Neonatal Edition). The aim of the first study was to determine if visual assessment of jaundice on day 2-3 of life is accurate in estimating serum bilirubin and...

Premature neonates frequently have inadequate respiratory function and require oxygen therapy during the weeks after birth. Since they are also exquisitely vulnerable to oxygen toxicity, careful monitoring of oxygen status is an essential component of neonatal intensive care.  Measuring % oxygen saturation by pulse...

Metabolic acidosis is the most common disturbance of acid-base balance among the critically ill of all ages, usually due to increased lactate production consequent on inadequate tissue perfusion and/or hypoxemia. The condition is characterized by primary reduction in bicarbonate and pH revealed during arterial blood...

All newborn babies have, by comparison with adults, a raised serum concentration of unconjugated (and therefore total) bilirubin, due principally to the transient increase in red cell destruction associated with the move from intrauterine support to physiological independence.  In close to half of all newborns the...

Premature, very-low-birth-weight babies have immature lungs and frequently require mechanical ventilation to ensure the gas (O₂, CO₂) exchange necessary for survival. Ventilation sufficiently aggressive to maintain partial pressure of carbon dioxide in blood (pCO₂) within normal limits can cause mechanical damage to...

Umbilical cord blood gas analysis provides objective evidence of neonatal condition at birth; a particular utility of the test is to identify those babies who have suffered significant oxygen deficit prior to delivery. Traditional obstetric practice is to clamp the umbilical cord within seconds of delivery but some...

Despite significant developments in neonatal medicine over the past decade or two there has been no overall reduction in the number of neonatal deaths according to the results of a recently published US study.  Researchers at the University of Colorado in Denver performed a retrospective study of all 779,385 live...

The ‘gold standard’ sample for blood gas analysis is arterial blood obtained via an indwelling arterial catheter or by arterial puncture. For a number of reasons capillary blood is an attractive substitute sample that is routinely used in some clinical settings.  The purpose of this article is to examine the evidence ...

Transient increase in serum bilirubin concentration is a normal physiological feature of the neonatal period and this rise is sufficient to cause visible jaundice in around 60 % of newborns. For most the condition is harmless and resolves spontaneously with no long-term effects. However for those neonates with...