In three different laboratories, adjustment of calcium values for
albumin using equations derived from their own regressions of calcium on
albumin in patients selcted by computer to be unlikely to have
disturbances of calcium homeostasis gave values which, after small
numbers of outliers were excluded by probit analysis, were identical
with their reference ranges in health (Barth JH et al, Ann Clin Biochem
1996; 33: 55-58). Clearly, panic values for total calcium cannot be
the same in patients with normal and abnormal albumin concentrations,
but they can for adjusted calcium. Why report total calcium?
Brian Payne
Myers Martin wrote:
>Alternative questions are:
>
>should the panic ranges and reported reference ranges be the same for
>corrected and non corrected calcium?
>should a reference range be quoted for both or just one (but which one)?
>should we have an EQA scheme for corrected calcium? (can we do a pilot
>jonathan?)
>
>regards
>
>martin myers
>
>
>
>
>-----Original Message-----
>From: Dr. M. Steiner [mailto:[log in to unmask]]
>Sent: 20 November 2003 07:48
>To: [log in to unmask]
>Subject: Panic values for total calcium?
>
>
>Dear colleagues,
>
>I would appreciate getting your opinion to help settle an ongoing debate
>related to total calcium panic values.
>There are certainly two fractions of requesting physicians. One would
>prefer only rather highly pathological concentrations (< 1.7 and > 3.5
>mmol/l) whereas the other one states that less pronounced changes should
>also immediately be communicated (< 1.9 and > 3.0 mmol/l).
>I am fully aware of the influence of low albumina on calcium in ICU
>patients and know of the advantages of ionised calcium. Still, some
>agreement needs to be achieved.
>Thank you very much for sharing your experience with us.
>
>Dr. med. Michael Steiner
>University of Rostock
>Institute of Clinical Chemistry & Pathobiochemistry
>D-18057 Rostock
>GERMANY
>
>------ACB discussion List Information--------
>This is an open discussion list for the academic and clinical
>community working in clinical biochemistry.
>Please note, archived messages are public and can be viewed
>via the internet. Views expressed are those of the individual and
>they are responsible for all message content.
>
>ACB Web Site
>http://www.acb.org.uk
>List Archives
>http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
>List Instructions (How to leave etc.)
>http://www.jiscmail.ac.uk/
>
>
>This message and any files transmitted with it are confidential and intended
>solely for the individual(s) addressed. If you have received this e-mail in
>error, disclosing, copying, distributing or retaining this message or any
>part of it is strictly prohibited; please notify the sender immediately and
>delete it from your system. Any views or opinions presented are solely those
>of the author and do not necessarily represent those of Lancashire Teaching
>Hospitals NHS Trust. The Trust accepts no liability for any damage caused by
>any virus transmitted with this e-mail, so although virus checked before
>transmission, the recipient should also check for the presence of viruses.
>
>------ACB discussion List Information--------
>This is an open discussion list for the academic and clinical
>community working in clinical biochemistry.
>Please note, archived messages are public and can be viewed
>via the internet. Views expressed are those of the individual and
>they are responsible for all message content.
>
>ACB Web Site
>http://www.acb.org.uk
>List Archives
>http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
>List Instructions (How to leave etc.)
>http://www.jiscmail.ac.uk/
>
>________________________________________________________________________
>This email has been scanned using the CleanPort MEF antivirus
>system. Funded for members by the Doctors.net.uk Bulletin service
>How does this protect me? http://www.Doctors.net.uk/qualityemail
>________________________________________________________________________
>
>
>
>
>
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|