PREDICTION OF ARTERIAL BLOOD GAS BY TRANSCUTANEOUS O2 AND CO2 IN CRITICALLY ILL HYPERDYNAMIC TRAUMA PATIENTS

1986 ◽  
Vol 26 (7) ◽  
pp. 684
Author(s):  
Curtis D. Stokes ◽  
Steve Blevins ◽  
Joan C. Stoklosa ◽  
Kathleen Cotter ◽  
Kim C. Goh ◽  
...  
Keyword(s):  
Critically Ill ◽  
Trauma Patients ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

CORRELATION OF VENOUS BLOOD GAS AND PULSE OXIMETRY WITH ARTERIAL BLOOD GAS IN CRITICALLY ILL PATIENTS

2021 ◽  
pp. 1-3
Author(s):  
Sritam Mohanty ◽  
Rangaraj Setlur ◽  
Jyoti Kumar Sinha
Keyword(s):  
Pulse Oximetry ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Gold Standard Method ◽  
Arterial Blood Gas ◽  
Arterial Blood

Introduction: Arterial blood gas (ABG) analysis is the gold standard method and frequently performed intervention to evaluate acid-base status along with adequacy of ventilation and oxygenation among patients with predominantly critical / acute diseases. Aims And Objectives: The aim of this study is to evaluate the correlation of VBG analysis and pulse oximetry (SpO2) with ABG analysis in critically ill patients. Materials And Methods:Intensive Care Unit (ICU), Command Hospital (Eastern Command), Kolkata, Adult patients requiring arterial blood gas analysis, JAN 2018 –JUNE 2019, 100 critically ill patients and Age – 18yrs and older, Sex – Either sex. Conclusion: In this study population of 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

A Practical Approach to Understanding Acid–Base Abnormalities in Critical Illness

2011 ◽  
Vol 24 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Amy L. Dzierba ◽  
Prasad Abraham
Keyword(s):  
Critical Illness ◽  
Problem Solving ◽  
Critically Ill ◽  
Therapeutic Interventions ◽  
Practical Approach ◽  
Blood Gas ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Base Disorder

Acid−base disorders are common in the critically ill. Arterial blood gas (ABG) analysis is frequently used to identify and manage acid−base disturbances. Using a systematic problem-solving approach to acid−base disturbances will facilitate the identification and assess the progression and severity of the metabolic and respiratory abnormality. The intent of this review is to examine acid−base physiology and regulation, provide a method to evaluate a patient’s acid−base disorder, and provide therapeutic interventions.

scholarly journals Predictive validity of a novel non-invasive estimation of effective shunt fraction in critically ill patients

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Emma M. Chang ◽  
Andrew Bretherick ◽  
Gordon B. Drummond ◽  
J Kenneth Baillie
Keyword(s):  
Critically Ill ◽  
Predictive Validity ◽  
Critically Ill Patients ◽  
Absolute Error ◽  
Shunt Fraction ◽  
Blood Gas ◽  
Computationally Efficient ◽  
Arterial Blood Gas ◽  
Non Invasive ◽  
Arterial Blood

Abstract Background Accurate measurement of pulmonary oxygenation is important for classification of disease severity and quantification of outcomes in clinical studies. Currently, tension-based methods such as P/F ratio are in widespread use, but are known to be less accurate than content-based methods. However, content-based methods require invasive measurements or sophisticated equipment that are rarely used in clinical practice. We devised two new methods to infer shunt fraction from a single arterial blood gas sample: (1) a non-invasive effective shunt (ES) fraction calculated using a rearrangement of the indirect Fick equation, standard constants, and a procedural inversion of the relationship between content and tension and (2) inferred values from a database of outputs from an integrated mathematical model of gas exchange (DB). We compared the predictive validity—the accuracy of predictions of PaO2 following changes in FIO2—of each measure in a retrospective database of 78,159 arterial blood gas (ABG) results from critically ill patients. Results In a formal test set comprising 9,635 pairs of ABGs, the median absolute error (MAE) values for the four measures were as follows: alveolar-arterial difference, 7.30 kPa; PaO2/FIO2 ratio, 2.41 kPa; DB, 2.13 kPa; and ES, 1.88 kPa. ES performed significantly better than other measures (p < 10-10 in all comparisons). Further exploration of the DB method demonstrated that obtaining two blood gas measurements at different FIO2 provides a more precise description of pulmonary oxygenation. Conclusions Effective shunt can be calculated using a computationally efficient procedure using routinely collected arterial blood gas data and has better predictive validity than other analytic methods. For practical assessment of oxygenation in clinical research, ES should be used in preference to other indices. ES can be calculated at http://baillielab.net/es.

Iatrogenic Anaemia in the Critically Ill: A Survey of the Frequency of Blood Testing in a Teaching Hospital Intensive Care Unit

2009 ◽  
Vol 10 (4) ◽  
pp. 279-281 ◽  
Author(s):  
Tim Astles
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Day Range ◽  
Arterial Blood ◽  
Blood Gas Analyses

Anaemia in the critically ill remains a contentious issue. Despite adoption of lower haemoglobin levels as transfusion triggers, many patients on intensive care units (ICUs) still require blood transfusions during their illness. One factor that contributes to the critically ill becoming anaemic is regular phlebotomy. Over a two week period, all blood tests performed on patients in a busy, teaching hospital ICU were surveyed to allow calculation of the total volume of blood that had been taken. On average, 52.4 mL of blood was taken per patient per day, and 366.8 mL per patient per week. The most frequently performed tests were arterial blood gas analyses, performed on average 5.8 times per patient per day (range 0–21 times per day). Arterial blood gas analysis alone accounted for taking of 29 mL of blood per patient per day, ie 203 mL per patient per week. Several methods for reducing the amount of blood taken from ICU patients have been identified and discussed. By implementing some of these simple changes in our institution, it would be possible to reduce the volume of blood taken by 43%.

scholarly journals Incidence of hyperoxia in trauma patients receiving pre-hospital emergency anaesthesia: results of a 5-year retrospective analysis

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
P. Leitch ◽  
A. L. Hudson ◽  
J. E. Griggs ◽  
R. Stolmeijer ◽  
R. M. Lyon ◽  
...  
Keyword(s):  
Major Trauma ◽  
Hospital Setting ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Trauma Patients ◽  
Blood Gas ◽  
Hospital Emergency ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis

Abstract Background Previous studies have demonstrated an association between hyperoxia and increased mortality in various patient groups. Critically unwell and injured patients are routinely given high concentration oxygen in the pre-hospital phase of care. We aim to investigate the incidence of hyperoxia in major trauma patients receiving pre-hospital emergency anesthesia (PHEA) in the pre-hospital setting and determine factors that may help guide clinicians with pre-hospital oxygen administration in these patients. Methods A retrospective cohort study was performed of all patients who received PHEA by a single helicopter emergency medical service (HEMS) between 1 October 2014 and 1 May 2019 and who were subsequently transferred to one major trauma centre (MTC). Patient and treatment factors were collected from the electronic patient records of the HEMS service and the MTC. Hyperoxia was defined as a PaO2 > 16 kPA on the first arterial blood gas analysis upon arrival in the MTC. Results On arrival in the MTC, the majority of the patients (90/147, 61.2%) had severe hyperoxia, whereas 30 patients (20.4%) had mild hyperoxia and 26 patients (19.7%) had normoxia. Only 1 patient (0.7%) had hypoxia. The median PaO2 on the first arterial blood gas analysis (ABGA) after HEMS handover was 36.7 [IQR 18.5–52.2] kPa, with a range of 7.0–86.0 kPa. SpO2 pulse oximetry readings before handover were independently associated with the presence of hyperoxia. An SpO2 ≥ 97% was associated with a significantly increased odds of hyperoxia (OR 3.99 [1.58–10.08]), and had a sensitivity of 86.7% [79.1–92.4], a specificity of 37.9% [20.7–57.8], a positive predictive value of 84.5% [70.2–87.9] and a negative predictive value of 42.3% [27.4–58.7] for the presence of hyperoxemia. Conclusion Trauma patients who have undergone PHEA often have profound hyperoxemia upon arrival at hospital. In the pre-hospital setting, where arterial blood gas analysis is not readily available a titrated approach to oxygen therapy should be considered to reduce the incidence of potentially harmful tissue hyperoxia.

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