DIESTRO 103APV4R ELECTROLYTE ANALYZER
122
JS Medicina Electrónica
4. Clinical interpretation
4.1 Low levels of cCa++ may be due to:
* Alkalosis
* Renal insufficiency
* Acute circulatory insufficiency
* Vitamin D deficiency
* Hipoparatiroidismo
4.2 Elevated levels of cCa++ may be due to:
* Cancer
* Tirotoxicosis
* Pancreatitis
* Immobilization
* Hyperparathyroidism
5. CONSIDERATIONS
Numerous factors can affect the measured values of cCa++. To minimize the errors that may be
made, it is recommended: no more than 30 seconds of stasis applied to the limb where the
sample is being taken; that the patient remains seated for more than 5 minutes before
venipuncture; for serum samples, use small tubes, without anticoagulant; for whole blood or
plasma samples, use tubes with balanced heparin; complete the sample tube in such a way as
to minimize the column of air over the sample, and process the sample within the first hour of
being taken.
Whole blood samples taken in tubes with Li or Na heparinate yield cCa++ values lower than
those obtained with the same sample without heparin. This is because heparin complexes
Ca++ and decreases it. There are commercially heparins with calcium balance that would
decrease this effect. If the amount of heparin added to the tube or syringe can be decreased,
then this error would decrease, but low levels of anticoagulant increase the risk of clotting the
sample.
Blood anticoagulated with oxalate or EDTA is not acceptable, as these compounds are strong
calcium chelators . Venous stasis and erect position can raise calcium. The stasis caused by
the maintenance of the tourniquet for more than one minute can lead to anaerobic glycolysis
with lactic acid production that decreases the pH and varies the free Ca++, since the Ca-
proteins union dissociates, finding increased values of cCa++.
Lithium Concentration: cLi+
1. Definition
cLi+(P) is the concentration of Lithium (Li+) in plasma, while cLi+(aP) is the equivalent for
arterial blood. In the Ion Analyzer it is displayed as Li+.
Summary of Contents for 103APV4R
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