Critical care profiling for informed treatment of severely ill patients.

Abstract

An important advance in critical care medicine is the availability of key biochemical test results at the patient's bedside within the brief period when they can be used to guide resuscitation and cardiovascular stabilization effectively. Frequently the menu of key tests, called a "critical care profile (CCP)," must be available to the attending clinician within 5 minutes to guide therapy in real time. Recent developments that make it possible to deliver a CCP with these 5 minutes include the ability to measure all of the analytes of the critical care profile on a whole-blood sample, and point-of-care testing. Today the results of a critical care profile can be available to the attending clinician within 5 minutes of his or her request by sampling approximately 200 microL of whole blood with a critical care instrument at or near a patient's bedside. Tests frequently recommended for a critical care profile include glucose, pO2, pCO2, pH, lactate, ionized calcium, potassium, sodium, ionized magnesium, and either hemoglobin concentration or hematocrit. Hospital areas that need critical care profile support include the emergency department, the operating room, and the intensive care unit.