Patients with sepsis, severe sepsis and/or septic shock are at increased risk of death and organ dysfunction.  While morbidity and mortality of patients with severe traumatic injury, acute myocardial infarction or stroke have been significantly reduced during recent years by the implementation of well-coordinated...

Over the years, as clinicians have learned how to utilize it, permissive hypercapnia has been finding a place in healthcare. However, it is important to bear in mind that numbers do not tell the entire story. It is imperative to understand the entire clinical picture before you act. For example, an acidic pH of 7.21...

PURPOSE – The purpose of this article is to discuss lean as a learning system in a hospital ward. DESIGN/METHODOLOGY/APPROACH – Discusses lean as a learning system in a hospital ward. FINDINGS – The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards’ context,...

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....

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...

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...

Sepsis and septic shock lead to local and systemic activation of different response systems, including coagulation and fibrinolysis.  Despite numerous attempts the high mortality rate of these patients has remained stable over the last 20 years. In this overview the pathophysiological insights and possible...

Recent studies of D-dimer as a “rule-out” test for deep venous thrombosis (DVT) frequently have used duplex ultrasound rather than venography as the gold standard. Because duplex ultrasound has limited ability to image the calf veins, there is potential for ultrasound studies to classify patients with calf DVT as...

Timely and accurate diagnosis of sepsis is of great importance for the choice of treatment, level of monitoring and prognosis. For this biomarkers could be a significant aid, and thus the search for and application of sepsis biomarkers are of great importance.  Current evidence suggests that C-reactive protein and...

Chest pain is a frequent cause of hospitalization and comprises a significant proportion of the acute medical workload in the western world. This issue is compounded for those living in regional or remote communities due to limited access to pathology services and tertiary-referral institutions. Evidence suggests...