Even the most expeditious stat laboratory cannot provide the immediate feedback of on-line biochemical sensing technology, although significant improvements have been made in in vitro biochemical analysis. The greatest improvements have been in reducing the turn-around time for results to become available and the amount of blood used for testing. FrankeJ etal (1.994). have recently evaluated the use of a bedside microanalyzer in the acute trauma setting. They found excellent correlation between test results from the microanalyzer and from a large batch analyzer used in the central laboratory. More importantly, the mean turn-around time was reduced tenfold by using the microanalyzer which also required less than 1 ml of blood. Phlebotomy for arterial blood gas or electrolyte analysis is quite common in the critical care setting. Consequently there is significant blood loss in this critically ill population as a result of attempts to understand their physiology better. Microanalyzers may play a significant role in improving our ability to care for the critically ill. They improve the turn-around time for test results and, more importantly, they minimize blood loss. In addition, since they are not as comprehensive as central laboratory tests, we may learn to be more judicious in ordering provocative tests which frequently have little impact on patient outcome.
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