For a number of years point-of-care blood lactate measurement has been used to predict outcome for patients suffering a range of critical illnesses. Now a recently published study suggests that this predictive value of lactate measurement can also be usefully applied to very-low-birth-weight (VLBW) neonates born...

Increased serum bilirubin, clinically manifest as jaundice, is very common during the first week of life, affecting around 60 % of full-term babies and 85 % of babies born prematurely. For the vast majority this neonatal jaundice is a mild transitory phenomenon with no long-term consequences. The greatest fear...

Blood gas analysis (BGA) provides the means for the most accurate assessment of patient oxygenation status; the two relevant blood gas parameters being partial pressure of oxygen in arterial blood (pO₂(a)), and % hemoglobin oxygen saturation (sO₂(a)).  Pulse oximetry, a technology now ubiquitous in all areas of...

Anemia, which is defined as hemoglobin (Hb) concentration The kidneys are essential to the regulation of red-cell production and thereby maintenance of normal Hb concentration because the hormone erythropoietin, which regulates red-cell production, is synthesized in the kidneys. The usually normochromic, normocytic...

Metformin is an oral hypoglycemic drug that has long been employed in the treatment of type 2 diabetes; it is particularly widely prescribed for those diabetics who are obese. Very rarely, metformin use results in severe lactic acidosis, most often occurring in patients with reduced renal function.  Although a very...

In health, serum potassium concentration is maintained within the approximate range of 3.5-5.2 mmol/L. Disturbance of potassium homeostasis is a common electrolyte disorder that is clinically manifest through its adverse effect on both skeletal and cardiac muscle cell function.  Although often asymptomatic, both...

Acetaminophen (alternative name paracetamol) is one of the most frequently used drugs and widely considered very safe in almost all clinical contexts so long as the maximum recommended dose is not exceeded.  When taken in overdose, however, it can cause acute liver failure (ALF). In fact, acetaminophen...

Anemia and consequent need for red-cell transfusion is a common feature of critical illness. According to a recently published review of the topic, nearly all (95 %) patients who have been in an intensive care unit for longer than 3 days become anemic.  For close to 50 % of these patients, anemia is considered of...

The 1999 US Institute of Medicine report "To Err is Human: Building a Safer Health Care System" provided an influential wake-up call for healthcare workers concerning the frequency of preventable medical errors. Initiatives over the past decade aimed at improving the safety of patient-sample testing represent just...

Arterial blood gas analysis is used to assess and monitor patient acid-base status. Disturbance of acid-base balance is classified to one of four main types depending on the pH, pCO₂(a) and bicarbonate results generated during blood gas analysis; the four types are respiratory acidosis, respiratory alkalosis,...