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Laboratory Critical Limits-Reply

Gerald J. Kost, MD, PhD
JAMA. 1990;264(3):335. doi:10.1001/jama.1990.03450030050020.
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In Reply.—  We have conducted two parallel national surveys of critical limits. One covered a broad cross section of medical institutions and trauma centers, the other, children's hospitals (Table). The table summarizes the use of SI units for representative critical limit tests and gives the factors for conversion of conventional to SI units.1 These results (from 92 US medical centers and 39 children's hospitals) lead to the following observations: (1) The majority of hospitals used conventional units, (2) electrolytes with simple conversion factors (eg, × 1) were often listed with SI units, (3) some tests introduced recently (eg, free or "ionized" calcium) were listed with SI units, (4) tests with methods traditionally using SI units (eg, ammonia) were listed that way, (5) tests with noninteger conversion factors (eg, glucose and bilirubin) generally were listed with conventional units, and (6) hematology and blood gas tests were listed with conventional

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