Towards Clinically Useful Expert Systems in Critical Care: Locally Managed Interpretation of Arterial Blood Gas Data

1997 ◽  
pp. 109-123
Author(s):  
G. A. Edwards ◽  
P. J. Compton ◽  
P. J. Preston ◽  
B. Ho Kang
Keyword(s):  
Critical Care ◽  
Expert Systems ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

An easy method for interpreting the results of arterial blood gas analysis

2001 ◽  
Vol 21 (5) ◽  
pp. 49-54 ◽  
Author(s):  
KM Kirksey ◽  
M Holt-Ashley ◽  
BK Goodroad
Keyword(s):  
Critical Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Critical Care Nurses ◽  
Blood Gas ◽  
Easy Method ◽  
Arterial Blood Gas ◽  
Confidence Levels ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis

Interpretation of acid-base disturbances is an essential skill for critical care nurses. Using the H model makes this process easy. When students and novice critical care nurses feel competent with certain skills, their confidence levels are greatly enhanced. One of us (K.M.K.) has been using the H model for many years to teach students how to interpret the results of arterial blood gas analysis. The students are often amazed at how easy and fun the model makes learning a subject many perceive as complex.

Emerging technology in critical care: continuous intra-arterial blood gas monitoring

1996 ◽  
Vol 5 (1) ◽  
pp. 55-65 ◽  
Author(s):  
NL Szaflarski
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Clinical Performance ◽  
Blood Gas ◽  
Gas Monitoring ◽  
Arterial Blood Gas ◽  
Blood Gas Monitoring ◽  
Arterial Blood ◽  
Critically Ill Adults

The blood-conserving technology of continuous intra-arterial blood gas monitoring has recently been introduced into the field of critical care. This type of monitoring is a real-time method for concomitantly assessing oxygenation, ventilation, and acid-base status in pediatric and adult populations through an indwelling (in vivo) sensor residing in a peripheral artery. This article examines the technology underpinning in vivo blood gas monitoring and reviews research documenting clinical performance, as well as benefits and clinical applications of three-analyte systems in critically ill patients. A majority of research has revealed clinically acceptable accuracy and reliability of in vivo blood gas sensors in critically ill adults subjected to a variety of adverse, but common, physiological conditions. Although most clinical research in critically ill adults has revealed good clinical performance of in vivo blood gas sensors, reports of aberrant blood gas values and sensor problems remain; no reports have been published to date evaluating continuous intra-arterial blood gas monitoring in children or infants. Many benefits of this technology have been postulated, and research examining its effect on patient and cost outcomes in critically ill populations is pending. Clinicians in critical care must keep abreast of this emerging technology, because it holds significant potential for improving the quality of care and outcomes of critically ill patients.

Does Implementing Pulse Oximetry in a Critical Care Unit Result in Substantial Arterial Blood Gas Savings?

CHEST Journal ◽  
1993 ◽  
Vol 104 (2) ◽  
pp. 542-546 ◽  
Author(s):  
Kevin J. Inman ◽  
William J. Sibbald ◽  
Frank S. Rutledge ◽  
Mark Speechley ◽  
Claudio M. Martin ◽  
...  
Keyword(s):  
Critical Care ◽  
Pulse Oximetry ◽  
Critical Care Unit ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

scholarly journals THE EFFECT OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE ABOUT ARTERIAL BLOOD GAS ANALYSIS AMONG THE STAFF NURSES WORKING IN CRITICAL CARE UNIT

2021 ◽  
Vol 9 (5) ◽  
pp. 1355-1361
Author(s):  
Priya Sachan ◽  
Swastika Das
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Staff Nurses ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Structured Teaching

Statement:A STUDY TO ASSESS THE EFFECT OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE ABOUT ARTERIAL BLOOD GAS ANALYSIS AMONG THE STAFF NURSES WORKING IN CRITICAL CARE UNIT OF SELECTED HOSPITAL, LUCKNOW Introduction: Arterial blood gas analysis is a basic and useful laboratory test for the critically ill patients. It is an essential investigation for assessing ventilation, oxygenation and acid base status among critically ill patients. These three are closely interrelated physiological parameters which maintain pH homeostasis. Measurement of arterial blood gas involves analysis of components: pH, partial pressure (PP), Base excess (BE), Bicarbonate (HCO3), Electrolytes, Haemoglobin (Hb) and Glucose.Interpreting an arterial blood gas (ABG) is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. Any deviation from a normal value will indicate that the client is experiencing an acid base imbalance. Disorders of acid-base balance can lead to severe complications and occasionally the abnormality may be so severe that it can lead to life threatening condition. Objectives Of The Study: 1. Assess the level of knowledge about Arterial Blood Gas analysis among the staff nurses working in the Critical Care Unit at selected Hospital. 2. Evaluate the effect of Structure Teaching Programme on level of knowledge about Arterial Blood Gas Analysis among the staff nurses working in the Critical Care Unit at selected Hospital. 3. Association between level of knowledge about Arterial Blood Gas analysis among the staff nurses working in the Critical Care Unit with selected demographic variables. Research Methodology:This study was conducted using Quantitative approach at Integral Hospital, Lucknow. Pre-experimental one group pre-test-post-test design was used in the study. The conceptual framework used in this study was Modified Kings Goal Attainment theory. The total sample size was 30 selected by convenience sampling technique. The data was collected by administering Structured Knowledge Questionnaire followed by Structured Teaching Programme about Arterial Blood Gas analysis. After 7 days, post-test was done to assess the effectiveness of STP. Reults:The data obtained are tabulated and analysed using descriptive and inferential statistics. The statistical analysis of the data shows that 86.7% of the staff nurses had moderate knowledge and 13.3% of the staff nurses had inadequate knowledge. The mean pretest knowledge score regarding Arterial Blood Gas analysis was 13.96 with a standard deviation of 3.39. After giving STP the mean score was increased to 23.00 with a standard deviation of 2.36. The Structured Teaching Programme was effective in improving the knowledge as the t value is -12.54 which was highly significant with the degree of freedom 29 p< 0.05. Conclusion: The findings revealed that there was a significant improvement in knowledge of staff nurses in post-test after structured teaching programme. It also showed that there was an association with pre-test knowledge and selected demographic variables like age and association of post-test knowledge and selected demographic variable like qualification.

Atrial fibrillation associated with carbon monoxide poisoning

2019 ◽  
pp. 203-206
Author(s):  
Mevlut Demir ◽  
◽  
Muslum Sahin ◽  
Ahmet Korkmaz ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Carbon Monoxide ◽  
Sinus Rhythm ◽  
Partial Pressure ◽  
Motor Vehicle ◽  
Carbon Monoxide Poisoning ◽  
Venous Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

Carbon monoxide intoxication occurs usually via inhalation of carbon monoxide that is emitted as a result of a fire, furnace, space heater, generator, motor vehicle. A 37-year-old male patient was admitted to the emergency department at about 5:00 a.m., with complaints of nausea, vomiting and headache. He was accompanied by his wife and children. His venous blood gas measures were: pH was 7.29, partial pressure of carbon dioxide (pCO2) was 42 mmHg, partial pressure of oxygen (pO2) was 28 mmHg, carboxyhemoglobin (COHb) was 12.7% (reference interval: 0.5%-2.5%) and oxygen saturation was 52.4%. Electrocardiogram (ECG) examination showed that the patient was not in sinus rhythm but had atrial fibrillation. After three hours the laboratory examination was repeated: Troponin was 1.2 pg/ml and in the arterial blood gas COHb was 3%. The examination of the findings on the monitor showed that the sinus rhythm was re-established. The repeated ECG examination confirmed the conversion to the sinus rhythm. He was monitored with the normobaric oxygen administration.

scholarly journals d-Cystine di(m)ethyl ester reverses the deleterious effects of morphine on ventilation and arterial blood gas chemistry while promoting antinociception

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Benjamin Gaston ◽  
Santhosh M. Baby ◽  
Walter J. May ◽  
Alex P. Young ◽  
Alan Grossfield ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Intracellular Signaling ◽  
Dimethyl Ester ◽  
Diethyl Ester ◽  
Blood Gas ◽  
Negative Effects ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Gas Chemistry ◽  
Ventilatory Drive

AbstractWe have identified thiolesters that reverse the negative effects of opioids on breathing without compromising antinociception. Here we report the effects of d-cystine diethyl ester (d-cystine diEE) or d-cystine dimethyl ester (d-cystine diME) on morphine-induced changes in ventilation, arterial-blood gas chemistry, A-a gradient (index of gas-exchange in the lungs) and antinociception in freely moving rats. Injection of morphine (10 mg/kg, IV) elicited negative effects on breathing (e.g., depression of tidal volume, minute ventilation, peak inspiratory flow, and inspiratory drive). Subsequent injection of d-cystine diEE (500 μmol/kg, IV) elicited an immediate and sustained reversal of these effects of morphine. Injection of morphine (10 mg/kg, IV) also elicited pronounced decreases in arterial blood pH, pO2 and sO2 accompanied by pronounced increases in pCO2 (all indicative of a decrease in ventilatory drive) and A-a gradient (mismatch in ventilation-perfusion in the lungs). These effects of morphine were reversed in an immediate and sustained fashion by d-cystine diME (500 μmol/kg, IV). Finally, the duration of morphine (5 and 10 mg/kg, IV) antinociception was augmented by d-cystine diEE. d-cystine diEE and d-cystine diME may be clinically useful agents that can effectively reverse the negative effects of morphine on breathing and gas-exchange in the lungs while promoting antinociception. Our study suggests that the d-cystine thiolesters are able to differentially modulate the intracellular signaling cascades that mediate morphine-induced ventilatory depression as opposed to those that mediate morphine-induced antinociception and sedation.

scholarly journals Analysis of Arterial Blood Gas Values Based on Storage Time Since Sampling: An Observational Study

2021 ◽  
Vol 11 (3) ◽  
pp. 517-521
Author(s):  
Alejandro Montero-Salinas ◽  
Marta Pérez-Ramos ◽  
Fernando Toba-Alonso ◽  
Leticia Quintana-DelRío ◽  
Jorge Suanzes-Hernández ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Observational Study ◽  
Partial Pressure ◽  
Group Analysis ◽  
Initial Time ◽  
Blood Gas ◽  
Initial Sample ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Prospective Longitudinal

Aim. To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method. Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results. The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions. The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results.

Reference intervals for venous blood gas measurement in adults

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Kirsty L. Ress ◽  
Gus Koerbin ◽  
Ling Li ◽  
Douglas Chesher ◽  
Phillip Bwititi ◽  
...  
Keyword(s):  
Partial Pressure ◽  
Meta Analysis ◽  
Venous Blood ◽  
Reference Interval ◽  
Reference Intervals ◽  
Published Data ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Venous Blood Gas

AbstractObjectivesVenous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.MethodsOne hundred and 51 adult volunteers (101 females, 50 males 18–70 y), were enrolled after completion of a health questionnaire. Venous blood was drawn into safePICO syringes and analysed on ABL827 blood gas analyser (Radiometer Pacific Pty. Ltd.). A non-parametric approach was used to directly establish the VBG RI which was compared to a calculated VBG RI based on a meta-analysis of differences between ABG and VBGResultsAfter exclusions, 134 results were used to derive VBG RI: pH 7.30–7.43, partial pressure of carbon dioxide (pCO2) 38–58 mmHg, partial pressure of oxygen (pO2) 19–65 mmHg, bicarbonate (HCO3−) 22–30 mmol/L, sodium 135–143 mmol/L, potassium 3.6–4.5 mmol/L, chloride 101–110 mmol/L, ionised calcium 1.14–1.29 mmol/L, lactate 0.4–2.2 mmol/L, base excess (BE) −1.9–4.5 mmol/L, saturated oxygen (sO2) 23–93%, carboxyhaemoglobin 0.4–1.4% and methaemoglobin 0.3–0.9%. The meta-analysis revealed differences between ABG and VBG for pH, HCO3−, pCO2 and pO2 of 0.032, −1.0 mmol/L, −4.2 and 39.9 mmHg, respectively. Using this data along with established ABG RI, calculated VBG RI of pH 7.32–7.42, HCO3− 23 – 27 mmol/L, pCO2 36–49 mmHg (Female), pCO2 39–52 mmHg (Male) and pO2 43–68 mmHg were formulated and compared to the VBG RI of this study.ConclusionsAn adult reference interval has been established to assist interpretation of VBG results.

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