From the Research
The Advanced Pediatric Life Support (APLS) laboratory tests include complete blood count (CBC), electrolytes, blood urea nitrogen (BUN), creatinine, glucose, calcium, blood gas analysis, liver function tests, coagulation studies, blood cultures, and urinalysis. These tests are essential for the comprehensive assessment of critically ill or injured children in emergency situations. The CBC helps identify infections, anemia, or bleeding disorders, while electrolytes and renal function tests assess fluid balance and kidney function. Glucose measurement is crucial as both hypoglycemia and hyperglycemia can occur in critically ill children. Blood gas analysis provides vital information about oxygenation, ventilation, and acid-base status. Liver function tests help identify hepatic dysfunction, while coagulation studies assess bleeding risk. Blood cultures are obtained when infection is suspected, and urinalysis can identify urinary tract infections or provide clues about systemic disorders. These tests should be ordered based on the clinical presentation and suspected pathology, with results interpreted in the context of the child's age, as normal values vary significantly throughout childhood development 1.
Some key points to consider when ordering these tests include:
- The importance of interpreting results in the context of the child's age, as normal values vary significantly throughout childhood development.
- The use of CBC components, such as white blood cell count and neutrophil-to-lymphocyte ratio, to predict cardiovascular and metabolic diseases 1.
- The role of blood cultures in diagnosing bloodstream infections, and the importance of obtaining adequate blood volume for culture, particularly in pediatric patients 2.
- The value of liver function tests and coagulation studies in assessing hepatic dysfunction and bleeding risk.
- The use of urinalysis to identify urinary tract infections or provide clues about systemic disorders.
Overall, the APLS laboratory tests are a crucial component of the comprehensive assessment and management of critically ill or injured children, and should be ordered and interpreted in a thoughtful and targeted manner, taking into account the child's age, clinical presentation, and suspected pathology.