I have to agree with Tim, serum calcium results are interpreted in the light of clinical assessment and other biochemical tests such as magnesium, PTH and vitamin D to arrive at the right clinical decision in the majority of patients. Clinicians have a long term familiarity with the reported total calcium and a change to ionised calcium reporting may bring its own problems/risks without resultant improvement in the management of patients with calcium disorders. ICU is probably one area where ionised calcium should be routinely available.
Best regards
Mohammad
Dr. M A Al-Jubouri, MB ChB, MSc, EurClinChem, FRCP Edin, FRCPath
Consultant Chemical Pathologist
--- On Wed, 19/6/13, Reynolds Tim (RJF) BHFT wrote:
> From: Reynolds Tim (RJF) BHFT
> Subject: Re: Population based algorithms
> To: [log in to unmask]
> Date: Wednesday, 19 June, 2013, 8:29
> Perhaps we should just admit that everything
> we measure is
> completely flawed and stop shut up shop entirely.
>
>
> alternativey, the point is that the numbers
> we produce have some
> function and allow patients to be triaged into those that
> need something done;
> those that don't; and those that are too late to care
> and simply need cremating.
> It does not matter that they are not perfectly precise and
> accurate because they
> only reflect part of a more complex system - We measure so
> little that it is
> like trying to work out who is going to win X-factor from
> the colour of the
> 150th Pixel from the left, and 300 down on the TV
> screen.
>
>
> TIM
>
>
> **************************************************************************************
>
>
> Prof. Tim
> Reynolds
> Consultant Chemical Pathologist /
> Clinical Director -
> Diagnostics / R&D Lead,
> Burton Hospitals NHS
> Foundation
> Trust
> work tel: 01283 511511 ext
> 4035
> work fax: 01283
> 593064
> work email:
> [log in to unmask]
>
> work URL:
> www.burtonhospitals.nhs.uk
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> From: Clinical
> biochemistry discussion list
> [mailto:[log in to unmask]] On Behalf Of
> Greg
> Watts
> Sent: 19 June 2013 12:29 AM
> To:
> [log in to unmask]
> Subject: Re: Population based
> algorithms
>
>
>
>
> Simon,
>
>
>
>
> That’s
> a great idea –
> but then we would have to do a pH adjusted ionised Ca++ if
> the samples are not
> anaerobic. You can’t win.
>
>
> Greg
>
>
>
>
>
>
>
> From: Clinical biochemistry discussion list
> [mailto:
> [log in to unmask] ] On Behalf Of Salter
> Simon (ROYAL FREE
> LONDON NHS FOUNDATION TRUST)
> Sent: Wednesday, 19
> June 2013 12:27
> AM
> To:
> [log in to unmask]
> Subject: Re:
> Population based
> algorithms
>
> Why can't we just measure ionised calcium
> on our main analysers and
> ditch total calcium methods and their equations?
>
>
> Simon
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