Blood samples for ammonia analysis do not require transport to the laboratory on ice: a study of ammonia stability and cause of ammonia increase in samples from patients with hyperammonaemia.

Objectives: Prompt recognition of hyperammonaemia can avoid severe consequences of delayed treatment. Strict sample transport requirements present barriers to requesting and, if not achieved, rejection by the laboratory. Evidence is sparse on ammonia stability from studies using modern techniques or based in clinical settings.

British Intestinal Failure Alliance (BIFA) guidance - haematological and biochemical monitoring of adult patients receiving home parenteral nutrition.

Home parenteral nutrition (HPN) is necessary for patients with prolonged intestinal failure which can be secondary to a variety of pathophysiological mechanisms or surgical resection. HPN is needed to supply micronutrients, macronutrients and water to reduce morbidity and mortality and to maximise the patient's quality of life. HPN requires close monitoring by a dedicated multidisciplinary team and is vital to minimise complications; both catheter related and metabolic.

Catheter-induced pulmonary artery rupture: haemodynamic compromise necessitates surgical repair.

Pulmonary artery haemorrhage is thankfully a very rare complication following pulmonary artery catheter insertion. It carries a significant mortality of 50%, and most cases are managed conservatively or with embolization therapy. We present an occult case, in which a patient presented with haemodynamic compromise without haemoptysis or significant haemothorax, who required surgical intervention.