Arterial blood gases

Arterial blood gas (ABGs) analysis forms the cornerstone of emergency respiratory investigation. In many situations values obtained dictate management strategy and facilitate decision-making. It is an uncomfortable procedure for the patients and if repeated ABGs are required, consider whether less invasive measures, such as respiratory rate, pulse oximetry or capillary blood gas measurements could be used....

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Faheem Shakur ◽  
Suzanne Mason

OBJECTIVES: Many patients with respiratory complaints who present to the Accident & Emergency (A & E) department have an arterial blood gas analysis performed at some point. It is our belief that there is no difference between arterial and capillary blood gas values in patients presenting to the A & E department. It is also anticipated that body temperature and blood pressure may play a part, so these will also be reported and associations will be investigated. METHODS: Patients who require arterial blood gas analysis at any stage during their stay in the A & E department at the Northern General hospital of Sheffield are eligible for inclusion in the study. In total there were 32 patients. PROCEDURE:Transvasin cream was applied to the ear lobe to improve local blood flow by dilating the capillaries. When ten minutes have elapsed after the application of the Transvasin cream, a capillary sample is taken from the ear lobe by the researchers. CONCLUSION: From the t-tests conducted, no significant difference was seen between the arterial and capillary blood gas samples for the parameters pO2 and O2 saturation. However, for pCO2, pH and [HCO3] there were significant differences observed. This result seems to disagree with the findings of most other studies that have so far shown stronger correlations generally for pH, pCO2 and bicarbonate, than for oxygen measuring parameters.


1997 ◽  
Vol 43 (1) ◽  
pp. 215-221 ◽  
Author(s):  
Robert T Brouillette ◽  
David H Waxman

Abstract Blood gas measurements and complementary, noninvasive monitoring techniques provide the clinician with information essential to patient assessment, therapeutic decision making, and prognostication. Blood gas measurements are as important for ill newborns as for other critically ill patients, but rapidly changing physiology, difficult access to arterial and mixed venous sampling sites, and small blood volumes present unique challenges. This paper discusses considerations for interpretation of blood gases in the newborn period. Blood gas measurements and noninvasive estimations provide important information about oxygenation. The general goals of oxygen therapy in the neonate are to maintain adequate arterial PaO2 and SaO2, and to minimize cardiac work and the work of breathing. Pulse oximetry and transcutaneous oxygen monitoring are extraordinarily useful techniques of estimating and noninvasively monitoring the neonate’s oxygenation, but each method has limitations. Arterial blood gas determinations of pCO2 provide the most accurate determinations of the adequacy of alveolar ventilation, but capillary, transcutaneous, and end-tidal techniques are also useful. An approach to and examples of acid-base disorders are presented. Three hemoglobin variants relevant to the newborn are considered: fetal hemoglobin, carboxyhemoglobin, and methemoglobin. Blood gases obtained in the immediate perinatal period can help assess perinatal asphyxia, but particular attention must be paid to the sampling site, the time of life, and the possible and proven diagnoses.


Author(s):  
Tom Scott ◽  
Hanna van Waart ◽  
Xavier CE Vrijdag ◽  
David Mullins ◽  
Peter Mesley ◽  
...  

Arterial blood gas (ABG) measurements at both maximum depth and at re-surfacing prior to breathing have not previously been measured during freedives conducted to extreme depth in cold open-water conditions. An elite freediver was instrumented with a left radial arterial cannula connected to two sampling syringes through a low-volume splitting device. He performed two open-water dives to 60 metres depth (197', 7 atmospheres absolute pressure) in the constant weight with fins competition format. ABG samples were drawn at 60 metres (by a mixed-gas scuba diver), and again on re-surfacing before breathing. An immersed surface static apnea, of identical length to the dives and with ABG sampling at identical times, was also performed. Both dives lasted approximately two minutes. PaO2 increased during descent from an indicative baseline of 15.8 kPa (after hyperventilation and glossopharyngeal insufflation) to 42.8 and 33.3 kPa (dives one and two), and decreased precipitously (to 8.2 and 8.6 kPa) during ascent. PaCO2 also increased from a low indicative baseline of 2.8 kPa to 6.3 and 5.1 kPa on dives one and two; an increase not explained by metabolic production of CO2 alone since PaCO2 actually decreased during ascent (to 5.2 and 4.5 kPa). Surface static apnea caused a steady decrease in PaO2 and increase in PaCO2 without the inflections provoked by depth changes. Lung compression and expansion provoke significant changes in both PaO2 and PaCO2 during rapid descent and ascent on a deep freedive. These changes generally support predictive hypotheses and previous findings in less extreme settings.


2020 ◽  
pp. 71-76
Author(s):  
Pat Croskerry

In this case, a 43-year-old male presents to the emergency department complaining of blurred vision during the past few days. He appears apprehensive. His eye examination is completely normal. On the basis of his increased respiratory rate and apprehension, a diagnosis of anxiety state is made, and he is discharged home. He returns the next day with continuing symptoms. On this occasion, an arterial blood gas is ordered, which eventually reveals his correct diagnosis.


1994 ◽  
Vol 3 (5) ◽  
pp. 353-355 ◽  
Author(s):  
ML Noll ◽  
JF Byers

Correlations of mixed venous and arterial oxygen saturation, heart rate, respiratory rate, and mean arterial pressure with arterial blood gas variables were computed for 57 sets of data obtained from 30 postoperative coronary artery bypass graft patients who were being weaned from mechanical ventilation. Arterial oxygen saturation and respiratory rate correlated significantly, although moderately, with blood gases.


1986 ◽  
Vol 9 (6) ◽  
pp. 427-432 ◽  
Author(s):  
R. Fumagalli ◽  
T. Kolobow ◽  
P. Arosio ◽  
V. Chen ◽  
D.K. Buckhold ◽  
...  

A total of 44 preterm fetal lambs at great risk of developing respiratory failure were delivered by Cesarean section, and were then managed on conventional mechanical pulmonary ventilation. Fifteen animals initially fared well, and 14 of these were long term survivors. Twenty-nine other lambs showed a progressive deterioration in arterial blood gases within 30 minutes of delivery, of which 10 lambs were continued on mechanical pulmonary ventilation (20% survival), while the remaining 19 lambs were placed on an extracorporeal membrane lung respiratory assist (79% survival). Extracorporeal membrane lung bypass rapidly corrected arterial blood gas values, and permitted the use of high levels of CPAP instead of the continuation of mechanical pulmonary ventilation at high peak airway pressures. Improvement in lung function was gradual, and predictable. Early institution of extracorporeal respiratory assist using a membrane artificial lung rapidly corrected arterial blood gas values and significantly improved on neonate survival.


2009 ◽  
Vol 28 (10) ◽  
pp. 665-670 ◽  
Author(s):  
Nastaran Eizadi-Mood ◽  
Sam Alfred ◽  
Ahmad Yaraghi ◽  
Chanh Huynh ◽  
Ali Shayesteh Moghadam

The aim of this study was to compare simultaneously obtained arterial and capillary blood gas (CBG) values in comatose-poisoned patients presented with stable vital signs. Forty-five adult patients with a diagnosis of coma because of poisoning and stable vital signs were included in this prospective study. With respect to pH, the arterial blood gas (ABG) and CBG values correlated satisfactorily (r2 = .91) and had an acceptable limit of agreements (LOAs; —0.04 to 0.06). With respect to base excess (BE), the ABG and CBG values correlated well (r2 = .85), but their 95% LOAs seem too wide to allow substitution (—4.4 to 2.7). PCO2 (r2 = .61), HCO3 (r2 = .71) and PO2 (r2 = .53) correlated less reliably. A capillary PCO2 of 51.7 mm Hg had a sensitivity of 100% and a specificity of 95.12% for detecting hypercarbia (area under the curve, 0.99; 95% Confidence Interval, 0.90-0.99; p < .0001). In conclusion, CBG analysis for pH may be a reliable substitute for ABG analysis in the initial evaluation of patients presenting with coma and stable vital signs to the poisoning emergency department (PED). Subsequent ABG may be required in patients with capillary PCO2 > 51.7 mm Hg.


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