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Articles by Ian E. Smith
Showing articles by "Ian E. Smith"
Article
July 2010
FAQ concerning the acid-base status of the blood
Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance? Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...
Blood gases/acid-base
Point-of-care testing
Glucose
Lactate
Creatinine/urea
Hemoglobins
Article
July 2010
Diagnosis of DVT with D-dimer testing and the Wells score
The following is a copy of an article from Evidence-Based Practice, 2007; 10(12):1-2.
Venous thromboembolism refers to a spectrum of disease that includes both pulmonary embolus and deep-venous thrombosis (DVT).
More than 250,000 people in the United States are diagnosed annually with venous thromboembolic disease;...
Coagulation/fibrinolysis
D-dimer
Article
April 2010
Benefit of using a D-dimer assay with a high clinical specificity
CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS).
Improving specificity of D-dimer assays would...
Coagulation/fibrinolysis
D-dimer
Article
April 2010
Hyperglycemic control in the ICU
Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.
However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....
Glucose
Point-of-care testing
Article
April 2010
NT-proBNP as a biomarker of cardioembolic stroke
In about 30-40 % of ischemic strokes, even after an extensive clinical investigation, it is not possible to determine any one etiology. It is possible that a fraction of these strokes, named cryptogenic, happen after an episode of paroxystic atrial fibrillation (AF) that was not registered. Strokes due to atrial...
Cardiac markers
Natriuretic peptide
Article
January 2010
Comparing D-dimer assays
When a new D-dimer method is to be implemented either as a substitute for a currently used D-dimer assay or as a supplement, maybe as a point-of-care assay, it is necessary to do a clinical comparison of the "old" assay versus the "new" assay. The major pitfalls in D-dimer comparisons are addressed in this paper.
...
Coagulation/fibrinolysis
D-dimer
Article
January 2010
Interpretation of laboratory results
Clinical laboratory test results are a very important parameter in diagnosis, monitoring and screening. 70-80 % of decisions in diagnosis are based on laboratory results and more and more laboratory analyses are requested. Thus a lot of data are provided and it is therefore imperative for patient care (and safety)...
Information management
Glucose
Creatinine/urea
D-dimer
CRP
Article
January 2010
Verification of methods and instruments
Analytical methods are often developed at one site and
transferred to other sites for routine use. Increasingly, the
method development is made by manufacturers of instruments and
reagents. Regulatory agencies have ruled that the
responsibility for the performance of IVDs in the laboratories
mainly should lie with...
Quality assurance
Creatinine/urea
Article
December 2009
Pediatric considerations in critical value assignment
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...
Neonatology
Bilirubin
Blood gases/acid-base
Electrolytes
Glucose
Creatinine/urea
Article
October 2009
Low troponin I concentrations and clinical decision making
Troponin values above the 99th percentile and increasing/falling values found by serial testing in addition to signs and symptoms of myocardial ischemia means AMI.
Low troponin values, near or below the 99th percentile, can be used for prognosis. Highest hazard ratios were found when using the 90th percentile,...
Cardiac markers
Troponins
Natriuretic peptide
