Acute Biochemistry

Acute Biochemistry is one of the three main areas of the Clinical Chemistry Department. Our name Acute Biochemistry applies to what tests we provide, and how we provide them.

‘Acute’ tests can indicate the presence or absence of diseases or illnesses that require prompt treatment. ‘Biochemistry’ means that we test important proteins, enzymes, ions, hormones and drugs found in the plasma fraction of blood samples and other body fluids.

High or low blood test results, taken singly or in combination with other such tests, can quickly reveal a diagnosis for very unwell children, the need for treatment or the effects of treatment. And of course these levels can alter quickly, sometimes over hours or days, as a patient’s condition alters.

Results

Acute Biochemistry test results can quickly be made available on-screen throughout the hospital, at the bedside, or with requesting doctors within minutes or hours depending on how urgent the situation is.

Results neither high nor low can simply reveal that a child’s condition is being effectively managed or they have got better.

Diagnoses

Most diagnoses can only be confirmed using a blood test result, and following this much routine monitoring of the same test levels and others is required over whichever time period is considered appropriate.

In all instances Acute Biochemistry staff have to be able to understand, operate, check and interpret the results from a variety of ‘analysers’. These use a variety of ingenious scientific measuring techniques, all in order that a rapid, accurate and reliable results service can be assured. About 70,000 of these tiny blood samples are analysed in Acute Biochemistry each year, with an average of five tests on each one.

Taking samples

A vital part of Acute Biochemistry activity takes place outside the lab in ward or clinic areas. Our highly-skilled team of phlebotomists and biomedical scientists have a great deal of contact with patients, their carers and ward staff. They take blood samples by heel/thumbprick from patients ranging in size from tiny 500g newborns to much larger teenagers. In addition they may also carry out sweat tests.

Point of Care Testing

Another important and growing part of what we do is called ‘POCT’ – Point Of Care Testing – meaning we can actually do the test on a small analyser like a glucose meter or blood gas analyser right there and then with the patient.

This can enable prompt treatment at the place where care can be given straight away – often the bedside or a clinic – rather than the longer process of sending a blood sample to the lab.

Being outside the lab means it is even more important to ensure our results are once again both accurate and reliable. All Clinical Chemistry tests are important.

Examples

Some examples of Acute Biochemistry tests are given below, along with their specific turnaround times. These may vary depending on the urgency of the patient condition.

• Plasma methotrexate – anti-cancer drug (2-12 hours)
• Blood cyclosporin – anti-transplant rejection drug (4 hours)
• Sweat chloride – high levels of this ‘sweat test’ can diagnose cystic fibrosis (2-7 days)
• U&Es – six quick tests can quickly give a snapshot of a patient’s kidney status and blood electrolyte balance (<1 hour)
• HbA1c – this POCT test in a diabetic clinic shows how high a patient’s blood glucose has been over a few months (minutes)