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What extreme laboratory values can be obtained that (some) patients can survive with?
Pim M W Janssens1, Michiel W Pot1, Moniek Wouters2
1Department of Clinical Chemistry and Haematology, Rijnstate Hospital, Arnhem, The Netherlands.
Objectives:
We wanted to have a more substantiated idea about the extreme values which are possible in patients not dying or being moribund.
Methods:
for nine regular analytes the five most extreme results registered between 2014 and 2018 in our database were searched. Results had to have been confirmed by multiple analyses in different samples. Patients should have lived at least 28 days after the extreme analyte value was observed. Patient diagnoses and symptoms were checked to understand the pathology and apparent consequences of the extreme values.
Results:
most extreme values (lowest and highest; mmol/L): sodium 100/178, potassium 1.2/9.8, chloride 58/138, total calcium 1.02/4.98, ionized calcium 0.37/2.44, magnesium 0.07/3.31, phosphate <0.1/7.3, pH <6.8/7.81, hemoglobin 1.3/14.9 in non-newborns; not determined/16.4 in newborns.
Conclusion:
All extreme values deviated 7 s.d. or more from the means. Patients obviously can survive rather deviant analyte values.
