Kost G J
Department of Clinical Chemistry, School of Medicine, University of California, Davis 95616.
JAMA. 1990 Feb 2;263(5):704-7.
A national survey determined critical limits used by trauma and medical centers in the United States. Mean low and high critical limits for the most frequently listed tests were the following values: glucose, 2.6 and 26.9 mmol/L; potassium, 2.8 and 6.2 mmol/L; calcium, 1.65 and 3.22 mmol/L; sodium, 120 and 158 mmol/L; hematocrit, 0.18 and 0.61; hemoglobin, 66 and 199 g/L; platelets, 37 x 10(9)/L and 910 X 10(9)/L; and white blood cell count, 2.0 X 10(9)/L and 37.0 X 10(9)/L. The high critical limit for prothrombin time was 27 seconds. Critical limits for PCO2 were 19 and 67 mm Hg; and for pH, 7.21 and 7.59. The low critical limit for PO2 was 43 mm Hg; no high critical limit was listed. The noncritical span for free calcium was 0.80 mmol/L. Important qualitative critical results included the presence of blasts on the blood smear, a Gram's stain or culture from blood or cerebrospinal fluid with positive results, and an elevated white blood cell count in the cerebrospinal fluid. A product of 15 years of collective medical judgment, these data should help physicians improve the quality and efficiency of acute patient care.
一项全国性调查确定了美国创伤和医疗中心所使用的危急值界限。最常列出的检查项目的低危急值和高危急值平均如下：葡萄糖，2.6和26.9毫摩尔/升；钾，2.8和6.2毫摩尔/升；钙，1.65和3.22毫摩尔/升；钠，120和158毫摩尔/升；血细胞比容，0.18和0.61；血红蛋白，66和199克/升；血小板，37×10⁹/升和910×10⁹/升；白细胞计数，2.0×10⁹/升和37.0×10⁹/升。凝血酶原时间的高危急值为27秒；二氧化碳分压的危急值为19和67毫米汞柱；pH值的危急值为7.21和7.59。氧分压的低危急值为43毫米汞柱；未列出高危急值。游离钙的非危急范围为0.80毫摩尔/升。重要的定性危急结果包括血涂片上出现原始细胞、血液或脑脊液的革兰氏染色或培养结果呈阳性以及脑脊液中白细胞计数升高。这些数据是15年集体医学判断的成果，应有助于医生提高急性病患者护理的质量和效率。
