Blood Gases and Critical Care Testing
Physiology, Clinical Interpretations, and Laboratory Applications
- 3rd Edition - October 8, 2021
- Imprint: Academic Press
- Authors: John G. Toffaletti, Craig R. Rackley
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 8 9 9 7 1 - 0
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 9 0 3 8 4 - 4
Blood gas tests are a group of tests that are widely used and essential for the evaluation and management of a patient’s ventilation, oxygenation, and acid-base balance, often in… Read more
Purchase options
Institutional subscription on ScienceDirect
Request a sales quoteBlood gas tests are a group of tests that are widely used and essential for the evaluation and management of a patient’s ventilation, oxygenation, and acid-base balance, often in emergent situations, and along with blood gases are other critical care analytes measured on blood: calcium, magnesium, phosphate, and lactate. Blood Gases and Critical Care Testing: Clinical Interpretations and Laboratory Applications, Third Edition, serves as your single most important reference for understanding blood gases and critical care testing and interpretation.
The third edition of this classic book is a complete revision and provides the fundamentals of blood gas (pH, pCO2, pO2) and other critical care tests (calcium, magnesium, phosphate, and lactate), including the history, the definitions, the physiology, and practical information on sample handling, quality control and reference intervals. Case examples with clear clinical interpretations of critical care tests have been included to all chapters.
This book will serve as a valuable and convenient resource for clinical laboratory scientists in understanding the physiology and clinical use of these critical care tests and for providing practical guidelines for successful routine testing and quality monitoring of these tests.
- Provides a step-by-step approach for organizing and evaluating clinical blood gas and critical care test results
- Describes several calculated parameters that are used by clinicians for evaluating a patient’s pulmonary function and oxygenation status and discusses clinical examples of their use
- This new edition includes more detailed information about reference intervals, not only for arterial blood, but for venous blood and umbilical cord blood, and for pH in body fluids
- Covers practical information on sample handling and quality control issues for blood gas testing
Pathologists, clinical chemists, clinical laboratory scientists, graduate students in laboratory studies, critical care physicians. Respiratory therapists, physicians in pulmonary medicine
- Cover image
- Title page
- Table of Contents
- Copyright
- About the authors
- Preface to third edition
- Chapter 1. Introduction to blood-gas tests and blood-gas physiology
- Introduction and history of blood gases
- Explanations of blood gas, acid–base, and cooximetry terms
- Anion gap
- Delta gap and delta ratio
- Strong ion difference
- Hemoglobin and derivatives
- sO2 and %O2Hb
- COHb and metHb
- DO2 and VO2
- Physiology of acid and base production
- Buffer systems
- Acid–base regulation
- Hemoglobin function
- Reference intervals for blood gases
- Self-assessment and mastery
- Answer Key:
- Chapter 2. Physiologic mechanisms and diagnostic approach to acid–base disorders
- Metabolic acidosis
- Metabolic alkalosis
- Respiratory acidosis
- Respiratory alkalosis
- Detecting mixed acid–base disorders
- Does the expected compensation occur?
- Diagnostic approach to acid–base disorders
- Summary of acid–base (pH, pCO2, and HCO3−) interpretations
- Complex acid–base case example (9)
- Self-assessment and mastery
- Case examples
- Chapter 3. Interpreting blood gas results on venous, capillary, and umbilical cord blood
- Physiologic differences between arterial and venous blood for blood gas and acid–base measurements
- Interpretation of venous blood gas values
- Capillary blood gases (neonatal)
- Umbilical cord blood gases
- Chapter 4. Disorders of oxygenation: hypoxemia and tissue hypoxia
- Introduction
- Parameters in oxygen monitoring
- Structure and function of hemoglobin
- Processes in oxygen transport and delivery to tissues and mitochondria
- Evaluation of hypoxemia
- Measured and calculated parameters for evaluating arterial oxygenation
- Methodology of oxygen measurements
- Self-assessment and mastery
- Self-assessment questions answer key
- Self-assessment cases and discussion
- Chapter 5. Calcium physiology and clinical evaluation
- Introduction and history
- Hypocalcemia
- Hypercalcemia
- Self-assessment
- Self-assessment and mastery discussion
- Chapter 6. Magnesium physiology and clinical evaluation
- Introduction
- Magnesium distribution and regulation in the blood
- Physiology
- Hypomagnesemia
- Hypermagnesemia
- Proper collection and handling of samples
- Reference intervals for magnesium
- Self-assessment and mastery
- Self-assessment and mastery discussion
- Chapter 7. Phosphate physiology and clinical evaluation
- Introduction
- Distribution in cells and blood
- Physiology and regulation
- Hypophosphatemia
- Hyperphosphatemia
- Self-assessment and mastery
- Self-assessment and mastery discussion
- Chapter 8. Osmolality, sodium, potassium, chloride, and bicarbonate
- Osmolality and volume regulation
- Sodium
- Hyponatremia
- Hypernatremia
- Potassium
- Hypokalemia
- Hyperkalemia
- Chloride
- Bicarbonate
- Self-assessment and mastery
- Chapter 9. Lactate physiology and diagnostic evaluation
- Introduction
- Physiology and metabolism
- Causes of hyperlactatemia
- Clinical approach to monitoring blood lactate
- Basic treatment strategies for elevated blood lactate
- Proper collection and handling of specimens for lactate testing
- Reference intervals for blood lactate
- Self-assessment
- Answer Key:
- Case examples
- Chapter 10. Collection and handling of samples: effects on blood gases, Na, K, ionized Ca, Mg, lactate, and phosphate analyses
- Sources of preanalytical errors in blood gas and electrolyte testing
- Proper collection and handling of samples
- Self-assessment questions
- Answer Key:
- Chapter 11. Quality control in blood gas and critical care testing
- Routine daily quality control on blood gas instruments
- Individualized Quality Control Plan
- Between-lab and between-instrument QC
- Detection of hemolysis in whole blood specimens
- Chapter 12. Models for point-of-care testing of critical care analytes
- Introduction
- Importance of POCT in answering clinical needs
- Types of POCT analyzers
- Selecting an analyzer for POCT
- Analyzer quality for POCT
- Information connectivity and data management
- Cost analysis for handheld versus hybrid analyzers
- Quality control techniques for POC testing
- Meeting compliance requirements by regulatory agencies
- Training and continuing compliance
- Case example: decisions in implementing a POCT system
- Index
- Edition: 3
- Published: October 8, 2021
- Imprint: Academic Press
- No. of pages: 264
- Language: English
- Paperback ISBN: 9780323899710
- eBook ISBN: 9780323903844
JT
John G. Toffaletti
John G. Toffaletti received a BS from the University of Florida in Gainesville and followed this with training in clinical chemistry at the University of North Carolina at Chapel Hill, where he earned a PhD in Biochemistry, then completed a Postdoctoral Fellowship in Clinical Chemistry at Hartford Hospital. Since completing these programs, he has worked in the Clinical Laboratories at Duke University Medical Center since 1979, where he is now Professor of Pathology, Director of the Blood Gas Laboratory, the Clinical Pediatric Laboratory, and several Outpatient Laboratories. He is also the Chief of Clinical Chemistry at the Durham VA Medical Center.
He has written or presented numerous workshops, books, study guides, chapters, and seminars on the interpretation of blood gas, cooximetry, ionized calcium, magnesium, lactate (sepsis), kidney function tests (creatinine, cystatin C, GFR), and viscoelastic testing (ROTEM and TEG). His research interests include sample collection, pre-analytical errors, analysis, and clinical use of these tests.
Affiliations and expertise
Director, Clinical Pediatric Laboratory, Duke University Medical Center, USACR
Craig R. Rackley
Dr. Craig R. Rackley specializes in pulmonary disease in Durham, North Carolina, and has over 18 years of experience in the field of medicine. He graduated from Georgetown University of Medicine with his medical degree in 2002 and is affiliated with numerous hospitals in North Carolina, including Duke University Medical Center, USA.
Affiliations and expertise
Assistant Professor, Duke University Medical Center, USARead Blood Gases and Critical Care Testing on ScienceDirect