Understanding parameters

Clinical chemistry influences almost all medical disciplines: most diagnoses are made or confirmed only after the laboratory has determined at least one or two parameters.

Photo: Understanding parameters

Accurate results are a precondition for correct treatment. In this process, values from the laboratory can rarely be determined as absolutely as body temperature or blood pressure. However, even if the values are not identical, they must at least be comparable. This sounds simple, but is difficult to achieve.

Inter-laboratory comparisons, conducted at regular intervals, document the range of accurate results produced by medical laboratories. Based on a series of results, European Hospital demonstrates how certain laboratory parameters differ and what effect this can have.

Finally, Professor Gerd Schellenberg, from the Centre of Life Sciences at Anhalt University of Applied Sciences in Bernburg, explained by using the example of allergies to bees and wasps (cf. EUR. HOSP. 3/2013 p. 8). In this issue, Professor Michael Spannagl, Specialist in Haemostasiology at the Munich University Hospital and Chairman of INSTAND e. V., describes an example taken from coagulation diagnostics:

Activated partial thrombin time (aPTT) measures plasmatic coagulation and is the only rapidly available parameter for monitoring heparinisation. This is important, for example, during interventions requiring catheterisation, when using extracorporeal systems to stabilise the cardiovascular system or for supporting lung function. Heparin suppresses the natural blood coagulation functions and thus prevents the formation of clots and thromboses.

The test value for a normal, healthy adult is usually below 40 seconds, while it is generally 60-80 seconds under heparin. This figure shows how differently a quality control sample with a pathological value (1 unit of unfractionated heparin was added per millilitre of blood plasma) is assessed by different analytical systems: The values measured by the 1,035 participating laboratories ranged between < 60 and > 135 seconds.

We can only imagine what might happen if a patient undergoing heparin treatment was transferred from a ‘low-value hospital’ to a ‘high-value hospital’: without the knowledge of the variability in aPTT measurements, the heparin dose could potentially be reduced or treatment discontinued entirely and this could cause a thrombosis. Conversely, if the patient was transferred in the ‘opposite direction’ the heparin dose could be doubled and this could trigger severe bleeding.

05.11.2013

More on the subject:
Read all latest stories

Related articles

Photo

Data protection

Ensuring your safe GDPR compliance

The General Data Protection Regulation (GDPR) requires changes in the healthcare sector. It is Greiner Bio-One’s aim to optimally fulfil these requirements with the help of its GeT system…

Photo

Politics

The S4 laboratory

Health always has a political dimension, as seen at two recent international events - the World Health Summit in Geneva in May and the G7 Summit in the Bavarian Alps near Garmisch at the beginning of…

Photo

Management

Labs need quality management systems

All laboratories should utilise quality monitoring systems and systematically work through their workflow processes to identify problem areas, according to Lucia Berte, who specialises in quality…

Related products

i-Solutions Health – LabCentre

LIS, Middleware, POCT

i-Solutions Health – LabCentre

i-SOLUTIONS Health GmbH
Medat – Laboratory Information System

LIS, Middleware, POCT

Medat – Laboratory Information System

Medat Computer-Systeme GmbH
Siemens Healthineers - syngo Lab Inventory Manager (sLIM)

LIS, Middleware, POCT

Siemens Healthineers - syngo Lab Inventory Manager (sLIM)

Siemens Healthineers