Clinical chemistry
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Medical diagnosis and therapeutic monitoring for critical illness require adaptation of laboratory analyses to the bedside. These are greatly helped by the modification of physiological and biochemical data-acquisition techniques to increase the number and accuracy of noninvasive variables that can be obtained from the patient. ⋯ I describe a noninvasive sensor system linked to a computer work-station that functions in a pattern recognition mode to permit classification of patients as to the type and severity of their physiological adaptation. This system can serve as a sophisticated bedside monitor of the severity of the patient's condition, as a guide to therapy.
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Approximately 2 million people die in the United States each year, 80% of them in acute- or chronic-care institutions. Physicians now have at their disposal interventions that can postpone death in almost every instance. ⋯ On the other hand, the fact that medical resources are becoming increasingly expensive and scarce will inevitably lead to rationing. The critical-care physician will be caught in the middle--orchestrating clinical care to balance the interests of individual patients and families against those of the larger community.
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To test the relationship pK' = 6.103 + log[HCO3calc] - log[HCO3meas], we used a Corning 168 blood-gas analyzer to analyze 500 blood samples for pH and PCO2, from which we calculated a value for bicarbonate. We also analyzed 500 venous blood samples, collected simultaneously, for potentiometric total carbon dioxide with the Ektachem 700 analyzer. ⋯ The results also confirmed the positive bias caused by organic acids in the Ektachem method for total carbon dioxide. Analysis of the SMA 6/60 results indicated a significant decrease of the pK' in patients classified as having a metabolic acidosis.