What extreme laboratory values can be obtained that (some) patients can survive with?

Abstract

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.

Keywords:

• Database
• patient
• laboratory
• pathology
• sodium
• potassium
• chloride
• calcium
• magnesium
• phosphate
• pH
• hemoglobin

Disclosure statement

No potential conflict of interest was reported by the authors.