scholarly journals Can peripheral venous blood gases replace arterial blood gases in emergency department patients?

CJEM ◽  
2002 ◽  
Vol 4 (01) ◽  
pp. 7-15 ◽  
Author(s):  
Louise C.F. Rang ◽  
Heather E. Murray ◽  
George A. Wells ◽  
Cameron K. MacGougan
Keyword(s):  
Venous Blood ◽  
Correlation Coefficients ◽  
Blood Gases ◽  
Blood Gas ◽  
Emergency Physicians ◽  
Peripheral Venous Blood ◽  
Arterial Blood ◽  
The Mean ◽  
Mean Differences ◽  
Venous Blood Gas

ABSTRACTObjective:To determine if peripheral venous blood gas values for pH, partial pressure of carbon dioxide (PCO2) and the resultant calculated bicarbonate (HCO3) predict arterial values accurately enough to replace them in a clinical setting.Methods:This prospective observational study was performed in a university tertiary care emergency department from June to December 1998. Patients requiring arterial blood gas analysis were enrolled and underwent simultaneous venous blood gas sampling. The following data were prospectively recorded: age, sex, presenting complaint, vital signs, oxygen saturation, sample times, number of attempts and indication for testing. Correlation coefficients and mean differences with 95% confidence intervals (CIs) were calculated for pH,PCO2and HCO3. A survey of 45 academic emergency physicians was performed to determine the minimal clinically important difference for each variable.Results:The 218 subjects ranged in age from 15 to 90 (mean 60.4) years. The 2 blood samples were drawn within 10 minutes of each other for 205 (96%) of the 214 patients for whom data on timing were available. Pearson’s product–moment correlation coefficients between arterial and venous values were as follows: pH, 0.913;PCO2, 0.921; and HCO3, 0.953. The mean differences (and 95% CIs) between arterial and venous samples were as follows: pH, 0.036 (0.030–0.042);PCO2, 6.0 (5.0–7.0) mm Hg; and HCO3, 1.5 (1.3–1.7) mEq/L. The mean differences (± 2 standard deviations) were greater than the minimum clinically important differences identified in the survey.Conclusions:Arterial and venous blood gas samples were strongly correlated, and there were only small differences between them. A survey of emergency physicians suggested that the differences are too large to allow for interchangeability of results; however, venous values may be valid if used in conjunction with a correction factor or for trending purposes.

scholarly journals Investigation of the Utility of Peripheral Venous Blood Gas Instead of Arterial Blood Gas in The Emergency Department

2013 ◽  
Vol 3 (2) ◽  
pp. 29-33
Author(s):  
Ertan Bakoğlu ◽  
Ali Sedat Kebapçıoğlu ◽  
Ahmet Ak ◽  
Abdullah Sadık Girişgin ◽  
İsmail Zararsız
Keyword(s):  
Emergency Department ◽  
Venous Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Peripheral Venous Blood ◽  
Arterial Blood ◽  
Venous Blood Gas

scholarly journals Can venous blood gas be a reliable substitute for arterial blood gases in modern clinical practice?

2019 ◽  
Vol 6 (4) ◽  
pp. 1016
Author(s):  
Sabiha Naz ◽  
Kiran Chugh ◽  
Isha Malik
Keyword(s):  
Venous Blood ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Emergency Setting ◽  
Blood Gas ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Venous Blood Gas

Background: It is clearly mentioned in the medicine books that blood gas analysis from arterial puncture is the gold standard. But in the past few years it is commonly seen that clinicians have started trusting on venous blood gas analysis as well as started advising VBG (Venous blood gas) in the initial diagnosis of critical patients in emergency setting. Keeping this fact in mind, we designed a study to determine whether VBG could be a better replacement of ABG (Arterial blood gases) in the emergency where diverse pathological conditions are encountered.Methods: This prospective cross-sectional study comprised of 50 patients of 20-60 yrs age with a variety of diagnoses admitted in the emergency department. 50 paired samples (ABG+VBG) were obtained from them under strict aseptic precautions after obtaining their verbal consent. With a minimum delay of less than 2 min blood gas analysis was performed on blood gas analyzer. Parameters (pH, PCO2, PO2, HCO3, Base Excess and O2 saturation) from ABG and VBG were recorded and compared using Student’s Unpaired ‘t’ test.Results: pH and HCO3 showed statistical significant (p value <0.05) differences between ABG and VBG, while BE showed statistical non-significant (p value >0.05) difference between them. Contrary to this, PCO2, PO2 and O2 saturation from ABG and VBG showed statistical highly significant (p value <0.0001) differences.Conclusions: VBG should not be interchangeably considered in place of ABG with regard to pH, HCO3, PCO2, PO2 and O2 saturation in conditions where actual oxygenation status of patient is required (e.g.; hypovolemic shock, respiratory disorders, mechanically ventilated patients, etc.)

scholarly journals Correlation of Venous Blood Gas and Pulse Oximetry With Arterial Blood Gas in the Undifferentiated Critically Ill Patient

2016 ◽  
Vol 33 (3) ◽  
pp. 176-181 ◽  
Author(s):  
Eli Zeserson ◽  
Ben Goodgame ◽  
J. Daniel Hess ◽  
Kristine Schultz ◽  
Cynthia Hoon ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pearson Correlation ◽  
Venous Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Venous Blood Gas ◽  
Oxygenation Status

Rationale: Blood gas analysis is often used to assess acid–base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. Objective: The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. Methods: We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ2, and Pearson correlation. Main Results: There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen–hemoglobin dissociation curve. Conclusion: In this population of undifferentiated critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis. The combination of VBG analysis plus SpO2 provided accurate information on acid–base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU.

scholarly journals Correlation of arterial blood gas measurement with peripheral venous blood gas values in adults patients admitted in ICU

2017 ◽  
Vol 5 (3) ◽  
pp. 11-17
Author(s):  
S Adhikari ◽  
S K Shrestha ◽  
B Srivastava ◽  
N B KC ◽  
B B Singh ◽  
...  
Keyword(s):  
Venous Blood ◽  
Gas Analysis ◽  
Care Practice ◽  
Blood Gas ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Peripheral Venous Blood ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Venous Blood Gas

Arterial blood gas (ABG) sampling is an essential investigation for assessment of acid-base status, oxygenation and ventilation in critical care practice. Arterial puncture to obtain arterial blood is more invasive procedure than venous and has more potential complications. To find out the correlation between arterial and peripheral venous blood gas values for pH, PCO2 and bicarbonate. Patients admitted in ICU requiring arterial blood gas analysis to determine their acid-base status or ventilatory status was included in the study. One milliliter of venous blood was obtained in a heparin flushed syringe within 5 minutes of getting arterial blood sample. Both labeled samples were processed immediately. Data were analyzed by student’s t-test. A total of 50 paired samples from 36 patients were evaluated. The mean differences between arterial and venous blood gas values for pH, PCO2 and bicarbonate were 0.02 units, -2.37 mmHg and -0.45 mEq/L respectively. Similarly, the correlation coefficients between arterial and venous parameters were 0.964, 0.881 and 0.906 for pH, PCO2 and bicarbonate respectively, which were statistically significant (p<0.001). Venous pH, PCO2 and bicarbonate showed a very high level of correlation with the respective arterial values.

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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