Since Meakins in 1927 described the relationship between increased blood lactate levels and the presence of oxygen debt (tissue hypoxia) in patients with circulatory shock [1], lactate levels have been used to diagnose and monitor the treatment of these patients. However, as lactate is a normal (end) product of...

Since the mid 1990's Point of Care Testing (POCT) has been viewed as a solution to a declared need for Short Turn Around Testing (STAT).  However, is it being utilized in a way that meets the needs of improving patient care and hospital quality assurance? What is STAT testing, why and how did it become POCT? How is...

Accreditation of medical laboratory examinations in the widest sense is becoming important as a management tool and a means to create confidence in results. The International Standard ISO/IEC 17025:1999 provides the general requirements for quality management system and technical competence, but the medical...

With the increasing number of blood tests performed at the point of care (POC), it has become more and more important to perform method comparison studies, comparing new methods to the existing methods used in the laboratory (LAB). This is done primarily to ensure that uniform results are reported throughout the...

It is more and more common that computer-based systems in hospitals are serviced or "looked after" by service engineers dialing in from remote locations.  The combination of highly computerized laboratory equipment and the emerging network technologies makes remote support a very attractive possibility. In many...

When performing method comparisons, it is important to address a number of preparatory and preanalytical issues to ensure that comparisons solely reflect the analytical differences between the two methods in question. This article provides preparatory and preanalytical checklists that can be used when comparing two...

The measurement of the electrolytes in blood is one of the most frequently performed measurements as the electrolytes are of major physiological importance for numerous functions of the body. Analysis of electrolytes such as sodium and potassium are performed in the traditional clinical chemistry laboratory, but are...

Children are not just small adults, and present unique challenges to the clinical laboratory. Blood specimens must be very small; for example, total blood volumes in a premature infant can be as small as 115 mL. Genetic diseases frequently must be detected in the newborn period. Reference values change with age....

Electronic fetal monitoring (EFM) during labor has been performed for 40 years. However, the specificity in diagnosing asphyxia is still insufficient. The combination of EFM and fetal scalp-blood sampling was introduced shortly after the introduction of EFM.  Although this monitoring ensures a better sensitivity and...

The concept of “metrological traceability” is important when establishing comparable clinical decision limits for a measured analyte at different hospitals within one country and in different countries.  This can only be achieved if all instrument manufacturers establish the performance characteristics of their...